A Case of Atypical Generalized Zoster with Suspicious Esophageal Involvement and Early Relapse in an Adult Renal Transplant Recipient / 대한이식학회지

ABSTRACT

An adult case of atypical generalized zoster six years after renal transplantation in a 30-year-old male is reported. He had generalized skin lesions and esophageal ulcers from the pharynx to the mid-esophagus. Serum ELISA tests for VZV antibody were positive for both IgM and IgG. Polymerase chain reaction for VZV-specific gene fragment was positive from the secretion of the cutaneous vesicles. Pre-transplantation work- up for serum IgG test for VZV showed a positive result seven years ago. He had been taking triple immunosuppressive drugs including cyclosporin A, deflazacort and mycophenolate mofetil. The skin lesions and esophageal ulcers improved substantially after high dose parenteral acyclovir therapy. He had a relapse of localized grouped vesicles 16 days later but the lesion improved after oral anti- viral therapy. In this case, suspicious esophageal, as well as disseminated cutaneous, involvement of VZV infection in an immunocompromised patient and its early relapse after recovery are unusual.