title: Prolonged varicella-zoster virus reinfection in an adult after unrelated cord blood transplantation.
abstract: Most varicella-zoster virus (VZV) infections after cord blood transplantation (CBT) present as localized herpes zoster. Here, we report a case of VZV reinfection in an adult patient after CBT that appeared clinically to be varicella. A 50-year-old Japanese man underwent CBT for the management of acute lymphoblastic leukemia. Seventeen months later, he developed a small number of vesicles with umbilicated centers. A skin biopsy showed an intraepidermal blister containing degenerated balloon cells. Subsequently, the skin eruption developed over his entire body. The patient was treated with intravenous acyclovir for 5 days, followed by oral valacyclovir for 9 days. It took more than 3 weeks for most of the skin lesions to scab. Serum levels of anti-VZV IgG on days 3 and 33 after the onset of the skin eruption were negative and 260 mIU/ml, respectively. Serum anti-VZV IgM on days 3 and 33 was not detected. Our patient was diagnosed with VZV reinfection.
authors.affiliation: Department of Dermatology, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Oka
authors.forename: Makoto
authors.initials: M
authors.lastname: Kunisada
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Oba
authors.forename: Atsuo
authors.initials: A
authors.lastname: Okamura
authors.forename: Chikako
authors.initials: C
authors.lastname: Nishigori
keywords: Cord blood transplantation; herpes zoster; reinfection; varicella; varicella-zoster virus