title: [Case of visceral varicella-zoster virus infection after autologous peripheral blood stem cell transplantation in which severe abdominal pain preceded the skin rash].
abstract: We report a 54-year-old man who developed visceral varicella-zoster virus (VZV) infection after autologous peripheral blood stem cell transplantation (auto-PBSCT) without using immunosuppressive agents for multiple myeloma. He suffered from severe abdominal pain 2 months after auto-PBSCT, and morphine chloride was needed to control it. Since the characteristic skin rash of VZV infection appeared over his entire body on the seventh hospital day, aciclovir was immediately started with favorable results. It is extremely difficult to diagnose VZV infection when severe abdominal pain proceeds and the eruptions characteristic of VZV infections are absent. This may also result in devastating delays in effective antiviral treatment. The increase in fat density around the celiac trunk and the root of the superior mesenteric artery on computed tomography shown in this case may has contributed to the correct diagnosis of visceral VZV infection.
authors.affiliation: Division of Gastroenterology and Hepatology, Nagaoka Red Cross Hospital, Japan. yamasato@nagaoka.jrc.or.jp
authors.forename: Satoshi
authors.initials: S
authors.lastname: Yamada
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Iwasaki
authors.forename: Akito
authors.initials: A
authors.lastname: Satoh
authors.forename: Yasunori
authors.initials: Y
authors.lastname: Tsuboi
authors.forename: Masahiko
authors.initials: M
authors.lastname: Yanagi
authors.forename: Toru
authors.initials: T
authors.lastname: Takahashi
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Usuda
authors.forename: Iwao
authors.initials: I
authors.lastname: Emura
mesh_terms: D000006:Abdomen, Acute / Q000209:etiology*; D015746:Abdominal Pain / Q000209:etiology*; D005076:Exanthema / Q000209:etiology*; D006562:Herpes Zoster / Q000150:complications* / Q000000981:diagnostic imaging; D006801:Humans; D016867:Immunocompromised Host; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000628:therapy; D036102:Peripheral Blood Stem Cell Transplantation; D014057:Tomography, X-Ray Computed; D014182:Transplantation, Autologous; D014781:Viscera