Molecular diagnosis of visceral herpes zoster

Patients with disseminated herpes tester may present with severe abdominal pain that results from visceral involvement of varicella-zoster-virus infection. In the absence of cutaneous eruptions of herpes tester, visceral herpes tester is extremely difficult to diagnose. This diagnostic difficulty has the potential to cause devastating delays in treatment. We report a case series of four patients with visceral herpes roster in whom large concentrations of DNA from varicella tester virus were detectable in blood by PCR before signs of infection appeared on the skin, thus enabling early diagnosis and treatment.