J Korean Soc Transplant.  2001 Jun;15(1):110-113.

A Case of Atypical Generalized Zoster with Suspicious Esophageal Involvement and Early Relapse in an Adult Renal Transplant Recipient

Affiliations
  • 1Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
  • 2Department of Clinical Pathology, Seoul National University College of Medicine, Seoul, Korea.
  • 3Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.

Abstract

An adult case of atypical generalized zoster six years after renal transplantation in a 30-year-old male is reported. He had generalized skin lesions and esophageal ulcers from the pharynx to the mid-esophagus. Serum ELISA tests for VZV antibody were positive for both IgM and IgG. Polymerase chain reaction for VZV-specific gene fragment was positive from the secretion of the cutaneous vesicles. Pre-transplantation work- up for serum IgG test for VZV showed a positive result seven years ago. He had been taking triple immunosuppressive drugs including cyclosporin A, deflazacort and mycophenolate mofetil. The skin lesions and esophageal ulcers improved substantially after high dose parenteral acyclovir therapy. He had a relapse of localized grouped vesicles 16 days later but the lesion improved after oral anti- viral therapy. In this case, suspicious esophageal, as well as disseminated cutaneous, involvement of VZV infection in an immunocompromised patient and its early relapse after recovery are unusual.

Keyword

Atypical generalized; Zoster; Renal transplantation; Esophagus; Early relapse

MeSH Terms

Acyclovir
Adult*
Cyclosporine
Enzyme-Linked Immunosorbent Assay
Esophagus
Herpes Zoster*
Humans
Immunocompromised Host
Immunoglobulin G
Immunoglobulin M
Kidney Transplantation
Male
Pharynx
Polymerase Chain Reaction
Recurrence*
Skin
Transplantation*
Ulcer
Acyclovir
Cyclosporine
Immunoglobulin G
Immunoglobulin M
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