A Boy with Ph1 Positive AML Developing Late On-Set Visceral Dissemination of Varicella-Zoster after Allogeneic Bone Marrow Transplantation

DOI 2 Citations 15 References
  • NISHIKURA Noriko
    Department of Pediatrics, Shiga University of Medical Science Department of Pediatrics, Ishibe Medical Center
  • NODA Yasuyo
    Department of Pediatrics, Shiga University of Medical Science
  • TAGA Takashi
    Department of Pediatrics, Shiga University of Medical Science
  • BAMBA Noriko
    Department of Pediatrics, Shiga University of Medical Science
  • KATO Hirohumi
    Department of Pediatrics, Shiga University of Medical Science
  • OHTA Shigeru
    Department of Pediatrics, Shiga University of Medical Science
  • TAKEUCHI Yoshihiro
    Department of Pediatrics, Shiga University of Medical Science

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Other Title
  • 遅発型内臓播種性水痘帯状疱疹ウイルス感染症をきたしたＰｈ１陽性急性骨髄性白血病の同種骨髄移植後症例

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Abstract

We reported a 15-year-old boy who developed fatal visceral dissemination of varicella-zoster virus (VZV) after his 2nd allogeneic stem cell transplantation for Phl positive acute myeloid leukemia (AML). At 12 years of age, he was given a diagnosis of Phi positive AML. On day 511 of the second stem cell transplantation, he was admitted for severe right epigastralgia. He had been treated with cyclosporin and prednisolone for chronic graft versus host disease. Laboratory findings, radiographic and ultrasonographic studies were performed but non-diagnostic. He was treated with various analgesics, but severe abdominal pain did not disappear. On the fifth day of his admission, vesicular skin eruptions appeared on his face and trunk. Then antiviral therapy with acyclovir (ACV) was started. However, he died of multiple organ failure on the following day. VZV was detected in the liver tissue obtained from the autopsy by using polymerase chain reaction (PCR). Visceral VZV infection should be considered in the case of patients who underwent hematopoietic stem cell transplantation developing severe acute abdominal pain. Early ACV administration and detection of VZV using PCR on blood or biopsy sample is recommended.

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