A case of fatal varicella zoster infection with refractory abdominal pain as an early symptom.

In economically developed countries over 95% of healthy adults have been exposed to varicella zoster virus (VZV) during childhood1). Therefore, not only primary infection but also reactivation with VZV are considered to be quite benign, and little consideration is given to the concomitant morbidity and mortality. It is the adult patient, along with the immunocompromised patient of any age, however, who will suffer the highest mortality rate from the VZV infection 2)~6) . One major investigation reported that infection with VZV occurred in 16.6% of bone marrow transplantation (BMT) patients and the mortality rate from visceral dissemination of VZV was 55%7). Therefore, to know the clinical features of the disseminated VZV infection is very important for an early diagnosis. Here we report a case of a patient, a recipient of an allogeneic BMT, who presented with refractory abdominal pain that was caused by visceral VZV infection as an early symptom, and discuss the importance of early diagnosis, treatment, and prevention of the disseminated VZV infection to immunocompromised patients.