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

Costa, E; Buxton, J; Brown, J; Templeton, KE; Breuer, J; Johannessen, I; (2016) Fatal disseminated varicella zoster infection following zoster vaccination in an immunocompromised patient. BMJ Case Reports , 2016 10.1136/bcr-2015-212688. (In press). Green open access

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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.

Type: Article
Title: Fatal disseminated varicella zoster infection following zoster vaccination in an immunocompromised patient
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1136/bcr-2015-212688
Publisher version: http://doi.org/10.1136/bcr-2015-212688
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Acyclovir, Aged, Fatal Outcome, Herpes Zoster, Herpes Zoster Vaccine, Humans, Leukemia, Lymphocytic, Chronic, B-Cell, Male, Renal Insufficiency, Respiratory Insufficiency
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Infection and Immunity
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Infection, Immunity and Inflammation Dept
URI: https://discovery.ucl.ac.uk/id/eprint/1553690
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