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Matsuo Y, Igarashi Y, Aoyama N, Satta Y, Oikawa R, Noguchi Y, Takahashi H, Matsumoto N, Yamamoto H, Itoh F. Visceral disseminated varicella-zoster virus infection in an immunocompetent host. Clin J Gastroenterol 2022; 15:568-574. [PMID: 35235151 DOI: 10.1007/s12328-022-01607-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Accepted: 02/07/2022] [Indexed: 11/25/2022]
Abstract
Varicella-zoster virus (VZV) can cause visceral disseminated VZV infection in immunocompromised patients. We experienced visceral disseminated VZV infection in an immunocompetent host. A 78-year-old woman visited our hospital complaining of abdominal pain that had persisted for 7 days. On day 3 after admission, a skin rash with blisters appeared mainly on her head and trunk that was diagnosed as generalized zoster via rapid skin VZV diagnostic kit. Esophagogastroduodenoscopy showed gastric erosions, and VZV was detected by real-time polymerase chain reaction testing of the gastric mucosal biopsy specimen. Computed tomography imaging also revealed pancreatitis and colitis, and she was diagnosed as having visceral disseminated VZV infection involving multiple organs. She was treated with acyclovir intravenously, after which her skin rash and abdominal pain disappeared. Because visceral disseminated VZV infection can occur in immunocompetent patients, this disease should be considered in patients with unexplained inflammatory lesions of the gastrointestinal tract or pancreas.
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Affiliation(s)
- Yasumasa Matsuo
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, St. Marianna University Yokohama Seibu Hospital, 1197-1 Yasashi-cho, Asahi-ku, Yokohama City, Kanagawa, 241-0911, Japan. .,St. Marianna University Toyoko Hospital, 3-435 Kosugimachi, Nakahara-ku, Kawasaki City, Kanagawa, 211-0063, Japan.
| | - Yosuke Igarashi
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, St. Marianna University Yokohama Seibu Hospital, 1197-1 Yasashi-cho, Asahi-ku, Yokohama City, Kanagawa, 241-0911, Japan
| | - Natsumi Aoyama
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, St. Marianna University Yokohama Seibu Hospital, 1197-1 Yasashi-cho, Asahi-ku, Yokohama City, Kanagawa, 241-0911, Japan
| | - Yosuke Satta
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, St. Marianna University Yokohama Seibu Hospital, 1197-1 Yasashi-cho, Asahi-ku, Yokohama City, Kanagawa, 241-0911, Japan
| | - Ritsuko Oikawa
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki City, 216-8511, Japan
| | - Yohei Noguchi
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, St. Marianna University Yokohama Seibu Hospital, 1197-1 Yasashi-cho, Asahi-ku, Yokohama City, Kanagawa, 241-0911, Japan
| | - Hideaki Takahashi
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, St. Marianna University Yokohama Seibu Hospital, 1197-1 Yasashi-cho, Asahi-ku, Yokohama City, Kanagawa, 241-0911, Japan
| | - Nobuyuki Matsumoto
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, St. Marianna University Yokohama Seibu Hospital, 1197-1 Yasashi-cho, Asahi-ku, Yokohama City, Kanagawa, 241-0911, Japan
| | - Hiroyuki Yamamoto
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki City, 216-8511, Japan.,Department of Bioinformatics, St. Marianna University Graduate School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki City, 216-8511, Japan
| | - Fumio Itoh
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki City, 216-8511, Japan
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Pennington MR, Cossic BGA, Perkins GA, Duffy C, Duhamel GE, Van de Walle GR. First demonstration of equid gammaherpesviruses within the gastric mucosal epithelium of horses. Virus Res 2017; 242:30-36. [PMID: 28870469 DOI: 10.1016/j.virusres.2017.09.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Revised: 08/31/2017] [Accepted: 09/01/2017] [Indexed: 12/25/2022]
Abstract
Horses commonly develop gastric mucosal ulcers, similar to humans, a condition known as equine gastric ulcer syndrome (EGUS) that can lead to poor performance and lost training time and care expenses. Unlike humans, however, an infectious bacterial cause of ulcers has not been conclusively identified. Herpesviruses, while well-established causative agents of diseases such as cold sores, genital lesions, and certain types of cancer, have also been implicated in the development of a subset of gastric ulcers in humans. The presence of equid herpesviruses in the gastrointestinal tract and their potential contribution to EGUS has not been evaluated. Here, we provide the first evidence of equid gammaherpesviruses 2 and 5 (EHV-2 and -5) within the epithelium of the gastric mucosa of horses. These viruses were initially detected by a nested PCR screen of gastric tissue samples obtained from client- and university-owned horses with and without ulcers; however, no association with EGUS was found in this limited sample set. We then validated a highly sensitive in situ hybridization (ISH) assay and used this assay to characterize the distribution of these viruses in necropsy gastric tissue samples from five racehorses. Analyses revealed frequent EHV-2 and EHV-5 co-infections within the gastric mucosal epithelium, regardless of the ulcer status. These results are the first to demonstrate the presence of equid gammaherpesviruses in the gastric mucosa of horses and warrants further investigation to determine the contribution of these viruses to the development of EGUS and/or other gastrointestinal diseases.
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Affiliation(s)
- Matthew R Pennington
- Baker Institute for Animal Health, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
| | - Brieuc G A Cossic
- Department of Biomedical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
| | - Gillian A Perkins
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
| | - Carol Duffy
- Department of Biological Sciences, College of Arts and Sciences, University of Alabama, Tuscaloosa, AL, USA
| | - Gerald E Duhamel
- Department of Biomedical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
| | - Gerlinde R Van de Walle
- Baker Institute for Animal Health, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA.
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Sastre Lozano VM, Martínez García P, Sánchez Sánchez C, Torregrosa Lloret M, Sevilla Cáceres L, Romero Cara P, Morán Sánchez S. Gastric varicella: two cases in cancer patients. Rev Esp Enferm Dig 2016; 108:670-672. [PMID: 26887434 DOI: 10.17235/reed.2016.3925/2015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Gastric involvement with the varicella-zoster virus is an uncommon clinical condition where early suspicion and diagnosis are important to prevent the consequences deriving from its high morbidity and mortality, which in immunocompromised patients oscillate between 9% and 41% according to the various series. Two cases of gastric involvement with the varicella-zoster virus (VZV) in two patients with blood cancer are reported below. Gastric lesions are usually preceded by typical papulovesicular skin lesions. When gastric involvement is the first symptom of the disease its diagnosis and management may be delayed, which may entail severe consequences for immunocompromised patients. It is therefore that we suggest its inclusion in the algorithm for immunocompromised patients with abdominal pain and ulcer-like endoscopic lesions.
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