Journal
PEDIATRIC HEMATOLOGY AND ONCOLOGY
Volume 25, Issue 3, Pages 237-242Publisher
INFORMA HEALTHCARE
DOI: 10.1080/08880010801938215
Keywords
dexamethasone; immunocompromised host; leukemia; varicella; visceral disease; VZV
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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 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.
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