Two Cases of Chickenpox Developed from an Immunocompromised Patient with Localized Herpes Zoster

Yong Chan Kim; Sang Hoon Han; Jun Yong Choi; Ju Hyun Lee; Jin Seok Kim; Kyungwon Lee

doi:10.14192/kjicp.2019.24.2.103

Journal List > Korean J Healthc Assoc Infect Control Prev > v.24(2) > 1140847

Go to TopGo to Top Go to BottomGo to Bottom

TOOLS

Kim, Han, Choi, Lee, Kim, and Lee: Two Cases of Chickenpox Developed from an Immunocompromised Patient with Localized Herpes Zoster

Case Report

Korean Journal of Healthcare-Associated Infection Control and Prevention 2019; 24(2): 103-107.

Published online: 31 December 2019

DOI: https://doi.org/10.14192/kjicp.2019.24.2.103

Two Cases of Chickenpox Developed from an Immunocompromised Patient with Localized Herpes Zoster

Yong Chan Kim¹, Sang Hoon Han²

, Jun Yong Choi², Ju Hyun Lee³, Jin Seok Kim², Kyungwon Lee⁴

¹Department of Infectious Disease, Ajou University School of Medicine, Suwon, Korea.

²Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.

³Infection Control Department, Severance Hospital, Seoul, Korea.

⁴Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, Korea.

Corresponding author: Sang Hoon Han. shhan@yuhs.ac

Received 19 November 2019 Revised 28 November 2019 Accepted 2 December 2019

Korean Society for Healthcare-Associated Infection Control and Prevention

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/).

Abstract

Varicella zoster virus causes chickenpox, which is highly contagious, at primary infection and herpes zoster at reactivation. The varicella zoster virus may be more contagious and cause serious outbreaks in immunocompromised patients. There are some reports of outbreaks of chickenpox in patients with herpes zoster. Here, we describe a case of localized herpes zoster occurring in an immunocompromised patient during hospitalization in a specialized ward for immunocompromised patients. This episode resulted in two newly developed, hospital-acquired cases of chickenpox. If we had isolated the index patient who had localized herpes zoster immediately, the two cases of chickenpox could have been prevented. Therefore, patients with localized herpes zoster should be isolated in wards with immunocompromised patients.

Keywords: Chickenpox, Herpes zoster, Immunocompromised host

Figures and Tables

Fig. 1

Histopathological examination of skin biopsy, taken from Case 2 patient, shows acantholysis and intranuclear inclusions at the infected cells (H&E=400×).

Fig. 2

Room arrangement of involved ward. The shade of each room shows nurses' duty. The dates indicate occurrences of hospital-acquired varicella after the development of skin lesion in index (Case 1) patient.

References

1. Cohen JI, Straus SE, Arvin AM. Varicella-Zoster Virus replication, pthogenesis and management. In : Fields BN, Knipe DM, Howley PM, editors. Fields' virology. 5th ed. Philadelphia: Lippincott Williams & Wilkins;2007. p. 2773–2818.

2. Juel-Jensen BE. Outbreak of chickenpox from a patient with immunosuppressed herpes zoster in hospital. Br Med J (Clin Res Ed). 1983; 286:60.

3. Saidel-Odes L, Borer A, Riesenberg K, Frenkel A, Sherlis R, Bouhnick L, et al. An outbreak of varicella in staff nurses exposed to a patient with localized herpes zoster. Scand J Infect Dis. 2010; 42:620–622.

4. LaRussa P. Clinical manifestations of varicella. In : Arvin AM, Gershon AA, editors. Varicella-zoster virus : virology and clinical management. Cambridge: Cambridge University Press;2000. p. 206–219.

5. Krah DL. Assays for antibodies to varicella-zoster virus. Infect Dis Clin North Am. 1996; 10:507–527.

6. Marin M, Güris D, Chaves SS, Schmid S, Seward JF. Advisory Committee on Immunization Practices, Centers for Disease Control and Prevention (CDC). Prevention of varicella: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep. 2007; 56(RR-4):1–40.

7. Arbeter AM, Starr SE, Plotkin SA. Varicella vaccine studies in healthy children and adults. Pediatrics. 1986; 78(4 Pt 2):748–756.

8. Huang YC, Lin TY, Chiu CH. Acyclovir prophylaxis of varicella after household exposure. Pediatr Infect Dis J. 1995; 14:152–154.

TOOLS

ORCID iDs: Sang Hoon Han
https://orcid.org/0000-0002-4278-5198
Similar articles