Varicella with rapidly progressive hepatitis presenting with multiple hepatic nodules in a child with acute leukemia.
J Infect Chemother
; 22(12): 822-825, 2016 Dec.
Article
em En
| MEDLINE
| ID: mdl-27496601
ABSTRACT
Abdominal pain may precede the characteristic varicella skin lesions in immunocompromised patients with visceral varicella. The absence of skin lesions may delay timely diagnosis and treatment of varicella for those patients. Furthermore, abdominal imaging findings to provide information to diagnose visceral varicella have rarely been reported. Varicella was diagnosed in a 5-year-old boy with acute lymphoblastic leukemia complaining of fever and abdominal pain followed by papulovesicular skin lesions. Later, the patient was found to have rapidly progressive acute hepatitis, and abdominal computed tomography showed multiple hypodense hepatic nodules. The patient was treated with intravenous acyclovir, intravenous immunoglobulin, and empirical antibiotic and antifungal therapy. However, his fever and abdominal pain persisted, and a laparoscopic liver biopsy was performed to differentiate other causes of the persisting symptoms. Eventually, the patient was diagnosed with visceral varicella based on histopathologic findings. In conclusion, visceral varicella should be considered in immunocompromised patients with abdominal pain and multiple hypodense hepatic nodules on abdominal imaging studies. However, bacteria, fungi, and tuberculosis can produce similar imaging findings; therefore, a biopsy may be necessary in patients not responding to antiviral therapy.
Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Dor Abdominal
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Varicela
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Leucemia-Linfoma Linfoblástico de Células Precursoras
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Hepatite
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Fígado
Tipo de estudo:
Etiology_studies
Limite:
Child, preschool
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Humans
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Male
Idioma:
En
Ano de publicação:
2016
Tipo de documento:
Article