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BMJ Case Rep. 2016 May 4;2016. pii: bcr2015212688. doi: 10.1136/bcr-2015-212688.

Fatal disseminated varicella zoster infection following zoster vaccination in an immunocompromised patient.

Author information

1
Royal Infirmary of Edinburgh, Edinburgh, UK.
2
Borders General Hospital, Melrose, UK.
3
Great Ormond St Hospital for Children, London, UK.
4
Department of Medical Virology, Royal Infirmary of Edinburgh, Edinburgh, UK.

Abstract

A 79-year-old man with chronic lymphocytic leukaemia presented with fever and a widespread vesicular rash on 19 November 2014. The patient had not been under immunosuppressive regime for 6 months. He had received a shingles vaccine on 14th October and developed flu-like symptoms after 2 weeks. Intravenous antimicrobial therapy including aciclovir was started. He remained stable with no evidence of systemic involvement. On day 5, he developed respiratory and renal failure that required transfer to intensive care unit. Vesicle fluid, bronchoalveolar lavage and plasma were positive for varicella zoster virus by PCR. Slight clinical improvement allowed extubation on day 16. He subsequently deteriorated and died on day 25. Multiorgan failure was considered the immediate cause of death whereas disseminated varicella zoster infection was stated in the medical certificate as the other condition leading to this outcome. Varicella zoster Oka vaccine strain was detected in vesicle fluid, using PCR.

PMID:
27147629
PMCID:
PMC4885517
DOI:
10.1136/bcr-2015-212688
[Indexed for MEDLINE]
Free PMC Article

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