Disseminated Varicella zoster infection with abdominal pain and periarterial fat stranding in a patient taking pomalidomide. Issue 1 (6th March 2020)

• Record Type: Journal Article
• Authors: Takada, Hiroaki; Kohara, Saeko; Ito, Takashi; Yoshioka, Hayato; Okada, Ichiro; Kiriu, Nobuaki; Koido, Yuichi; Hasegawa, Eijyu
• Is Part Of: Acute medicine & surgery. Volume 7:Issue 1(2020)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2020-03-06
• Subjects: Abdominal fat -- gastroenterology and hepatology -- pomalidomide -- sepsis/multiple organ failure -- Varicella zoster virus infection; Surgery -- Periodicals; Medical emergencies -- Periodicals; 617.005
• DOI: 10.1002/ams2.494
• Languages: English
• ISSNs: 2052-8817

Abstract

Abstract : Background: Disseminated Varicella zoster virus infection (DVI) is a severe infection associated with severe abdominal pain of unknown cause. We report a case in which periarterial (the celiac artery and superior mesenteric artery) fat stranding (PFS) on computed tomography (CT) was the presumed cause of abdominal pain in a patient taking pomalidomide. Case Presentation: A 62‐year‐old woman was admitted to our hospital with abdominal pain. Her medical history was multiple myeloma treated with pomalidomide. Computed tomography showed no remarkable findings on admission, but 1 day later, a contrast‐enhanced CT showed PFS. A skin eruption appeared on day 4 and we started acyclovir. On day 10, Varicella zoster virus antigen and antibody tests were positive, confirming the diagnosis of DVI. The abdominal pain subsequently improved, together with the PFS, and she was discharged. Conclusion: When patients present with severe abdominal pain and PFS, DVI and acyclovir must be considered. Abstract : We report a case of in which periarterial (the celiac artery and superior mesenteric artery) fat stranding on computed tomography was the presumed cause of abdominal pain in a patient taking pomalidomide.