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SHR Neuro Cancer Cardio Lipid Metab Microb
Wiegering, V; Schick, J; Beer, M; Weissbrich, B; Gattenlohner, S; Girschick, HJ; Liese, J; Schlegel, PG; Eyrich, M.
Varicella-zoster virus infections in immunocompromised patients - a single centre 6-years analysis
BMC Pediatr. 2011; 11(Pt 10):31-31
Doi: 10.1186/1471-2431-11-31
(- Case Report)
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- Co-authors Med Uni Graz
- Beer Meinrad
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- Abstract:
- Background: Infection with varicella-zoster virus (VZV) contemporaneously with malignant disease or immunosuppression represents a particular challenge and requires individualized decisions and treatment. Although the increasing use of varicella-vaccines in the general population and rapid initiation of VZV-immunoglobulins and acyclovir in case of exposure has been beneficial for some patients, immunocompromised individuals are still at risk for unfavourable courses. Methods: In this single center, 6-year analysis we review incidence, hospitalization and complication rates of VZV-infections in our center and compare them to published data. Furthermore, we report three instructive cases. Results: Hospitalization rate of referred children with VZV-infections was 45%, among these 17% with malignancies and 9% under immunosuppressive therapy. Rate of complications was not elevated in these two high-risk cohorts, but one ALL-patient died due to VZV-related complications. We report one 4-year old boy with initial diagnosis of acute lymphoblastic leukemia who showed a rapidly fatal outcome of his simultaneous varicella-infection, one 1.8-year old boy with an identical situation but a mild course of his disease, and an 8.5-year old boy with a steroid-dependent nephrotic syndrome. This boy developed severe hepatic involvement during his varicella-infection but responded to immediate withdrawl of steroids and administration of acyclovir plus single-dose cidofovir after nonresponse to acyclovir after 48 h. Conclusion: Our data show that patients with malignant diseases or immunosuppressive therapy should be hospitalized and treated immediately with antiviral agents. Despite these measures the course of VZV-infections can be highly variable in these patients. We discuss aids to individual decision-making for these difficult situations.
- Find related publications in this database (using NLM MeSH Indexing)
- Acyclovir - therapeutic use
- Antiviral Agents - therapeutic use
- Chickenpox - diagnosis Chickenpox - drug therapy Chickenpox - immunology
- Child -
- Child, Preschool -
- Cytosine - analogs and derivatives Cytosine - therapeutic use
- Female -
- Herpes Zoster - diagnosis Herpes Zoster - drug therapy Herpes Zoster - immunology
- Herpesvirus 3, Human - drug effects Herpesvirus 3, Human - immunology
- Hospitalization - statistics and numerical data
- Humans -
- Immunocompromised Host - drug effects Immunocompromised Host - immunology
- Incidence -
- Infant -
- Male -
- Phosphonic Acids - therapeutic use
- Practice Guidelines as Topic -
- Find related publications in this database (Keywords)
- varicella-zoster virus immunosuppression
- pediatrics
- cidofovir