title: Fatal visceral varicella-zoster virus infection without skin involvement in a child with acute lymphoblastic leukemia.
abstract: A 5-year-old girl with acute lymphoblastic leukemia in remission suffered from fatal visceral varicella-zoster virus (VZV) infection after the oral administration of a high-dose dexamethasone. She abruptly developed fulminant hepatitis and disseminated intravascular coagulation, and died 3 days later. VZV DNA and antigens were detected in the peripheral blood (6 x 10(8) copies/mL) and a postmortem liver specimen, respectively. The exposure to VZV was not confirmed and no skin lesions were observed. VZV infection should be considered in patients with unexplained liver dysfunction under severe immunosuppressive condition, even in the absence of viral exposure and skin involvement.
authors.affiliation: Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. matsuzaki@shs.kyushu-u.ac.jp
authors.forename: Akinobu
authors.initials: A
authors.lastname: Matsuzaki
authors.forename: Aiko
authors.initials: A
authors.lastname: Suminoe
authors.forename: Yuhki
authors.initials: Y
authors.lastname: Koga
authors.forename: Koichi
authors.initials: K
authors.lastname: Kusuhara
authors.forename: Takuya
authors.initials: T
authors.lastname: Hara
authors.forename: Reina
authors.initials: R
authors.lastname: Ogata
authors.forename: Tetsutaro
authors.initials: T
authors.lastname: Sata
authors.forename: Toshiro
authors.initials: T
authors.lastname: Hara
mesh_terms: D000956:Antigens, Viral / Q000097:blood; D018931:Antineoplastic Agents, Hormonal / Q000008:administration & dosage; D002644:Chickenpox / Q000097:blood / Q000188:drug therapy / Q000209:etiology*; D002675:Child, Preschool; D004279:DNA, Viral / Q000097:blood; D003907:Dexamethasone / Q000008:administration & dosage; D004211:Disseminated Intravascular Coagulation / Q000209:etiology; D017809:Fatal Outcome; D005260:Female; D014645:Herpesvirus 3, Human; D006801:Humans; D017114:Liver Failure, Acute / Q000209:etiology; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000097:blood / Q000150:complications* / Q000188:drug therapy
chemical_list: D000956:Antigens, Viral; D018931:Antineoplastic Agents, Hormonal; D004279:DNA, Viral; D003907:Dexamethasone