Use of intravenous immunoglobulin in a disseminated varicella infection in an immunocompromised child
Korean Journal of Pediatrics 2014³â 57±Ç 8È£ p.370 ~ p.373
±èÀçÈ«(Kim Jae-Hong) - Catholic University College of Medicine Department of Pediatrics
±Ç´ëÇö(Kwon Dae-Hyun) - Catholic University College of Medicine Department of Pediatrics
¹èÀÌ¿µ(Bae E-Young) - Catholic University College of Medicine Department of Pediatrics
Çѽ¹ü(Han Seung-Beom) - Catholic University College of Medicine Department of Pediatrics
ÀÌÀç¿í(Lee Jae-Wook) - Catholic University College of Medicine Catholic Blood and Marrow Transplantation Center
Á¤³«±Õ(Chung Nack-Gyun) - Catholic University College of Medicine Catholic Blood and Marrow Transplantation Center
Á¤´ëö(Jeong Dae-Chul) - Catholic University College of Medicine Department of Pediatrics
Á¶ºó(Cho Bin) - Catholic University College of Medicine Catholic Blood and Marrow Transplantation Center
°ÁøÇÑ(Kang Jin-Han) - Catholic University College of Medicine Department of Pediatrics
±èÇбâ(Kim Hack-Ki) - Catholic University College of Medicine Catholic Blood and Marrow Transplantation Center
Abstract
Varicella-zoster virus infection can lead to severe illness in immunocompromised patients. Further the mortality rate of disseminated varicella infection is extremely high particularly in immunocompromised children. We report a case of disseminated varicella infection in a child with acute lymphoblastic leukemia who was receiving chemotherapy, but was initially admitted with only for acute abdominal pain. The patient rapidly developed severe complications, including acute respiratory distress syndrome, acute hepatitis, disseminated intravascular coagulation, and encephalopathy. Acyclovir is a highly potent inhibitor of varicella-zoster virus infection. However, owing to rapid disease progression, it might not be sufficient to control a disseminated varicella infection, especially in immunocompromised patients. Immunoglobulin neutralize virus invasion and suppress viremia, acting synergistically with acyclovir. In this case, early administration of acyclovir and a high-dose of immunoglobulin, combined with mechanical respiratory support, proved adequate for treatment of this severe illness.
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Varicella-zoster virus, Acyclovir, Immunoglobulin
KMID :
1130320140570080370
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