pISSN 2671-8790 eISSN 2671-8804


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Korean J Transplant

Published online May 3, 2022

© The Korean Society for Transplantation

Fulminant hepatitis and myocarditis associated with varicella zoster virus infection in a kidney transplant recipient: a case report

Jeayeon Park1 , Minjung Kang1 , Jongwon Ha2 , Hajeong Lee1

1Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
2Department of Surgery, Seoul National University Hospital, Seoul, Korea

Correspondence to: Hajeong Lee
Division of Nephrology, Department of Internal Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Korea
Tel: +82-2-2072-4905
Fax: +82-2-762-9662
E-mail: mdhjlee@gmail.com

Received: February 24, 2022; Revised: March 21, 2022; Accepted: March 24, 2022

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.


Varicella zoster virus (VZV) infection can follow a virulent course, leading to possible infection-related mortality in immunocompromised hosts. Visceral disseminated VZV infection is a rare disease with a high mortality rate in immunocompromised patients. We present a case of acute liver failure and acute myocarditis due to visceral disseminated VZV infection in an immunocompromised patient who had recently received kidney transplantation and who subsequently showed dramatic improvement after treatment with intravenous acyclovir and intravenous immunoglobulin. Severe epigastric pain preceded the vesicular skin lesions; therefore, the diagnosis and treatment could have been delayed. Such delays have caused mortality in most previous cases. Therefore, it is necessary to consider visceral disseminated viral infection in the differential diagnosis of immunocompromised patients when multi-organ failure progresses with an unknown cause.

Keywords: Varicella zoster virus infection, Liver failure, Myocarditis, Kidney transplantation, Case report