کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
---|---|---|---|---|
8733502 | 1590681 | 2017 | 6 صفحه PDF | دانلود رایگان |
عنوان انگلیسی مقاله ISI
Visceral varicella-zoster virus (VZV) infection as an underestimated differential diagnosis of acute abdomen in a patient after allogeneic hematopoietic stem cell transplantation
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کلمات کلیدی
موضوعات مرتبط
علوم زیستی و بیوفناوری
ایمنی شناسی و میکروب شناسی
ایمونولوژی
پیش نمایش صفحه اول مقاله
![عکس صفحه اول مقاله: Visceral varicella-zoster virus (VZV) infection as an underestimated differential diagnosis of acute abdomen in a patient after allogeneic hematopoietic stem cell transplantation Visceral varicella-zoster virus (VZV) infection as an underestimated differential diagnosis of acute abdomen in a patient after allogeneic hematopoietic stem cell transplantation](/preview/png/8733502.png)
چکیده انگلیسی
We report a case of 18-year-old male patient who 5.5 months after allogeneic hematopoietic stem cell transplant (HSCT) developed severe abdominal pain not responding to high dose of opioids. The pain was accompanied by gradually increasing activity of liver enzymes and bilirubin concentration. The patient had a history of acute GVHD and was on steroid taper. Importantly, he was also temporarily off standard acyclovir prophylaxis. Provisional diagnosis of acute cholecystitis was made, however, cholecystectomy did not improve patient's condition. Clinical picture of severe abdominal pain without clear surgical cause, resistant to high doses of opiates with increasing activity of liver enzymes was highly suspicious of visceral varicella zoster virus (VZV) reactivation. Immediate introduction of intravenous acyclovir led to full recovery and complete resolution of abdominal pain. We conclude that reactivation of latent VZV with absent or delayed occurrence of characteristic skin vesicles may still pose a diagnostic challenge resulting in delay of the proper diagnosis and start of life saving antiviral treatment. Severe intractable pain in HSCT recipients with increasing activity of liver enzymes should evoke high index of suspicion of the possible disseminated VZV and impose start of empirical treatment with high dose acyclovir.
ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Acta Haematologica Polonica - Volume 48, Issue 4, OctoberâDecember 2017, Pages 372-377
Journal: Acta Haematologica Polonica - Volume 48, Issue 4, OctoberâDecember 2017, Pages 372-377
نویسندگان
Julia RadoÅ-Proskura, Ninela Irga-Jaworska, Anna Malinowska, Jan Maciej Zaucha,