September 26, 1994

Varicella Hepatitis: A Fatal Case in a Previously Healthy, Immunocompetent AdultReport of a Case, Autopsy, and Review of the Literature

Author Affiliations

From the Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY (Mr Anderson and Drs Klainer and Bisaccia); and Departments of Internal Medicine (Drs Schwartz, Bisaccia, and Klainer) and Pathology (Dr Hunter), Morristown (NJ) Memorial Hospital.

Arch Intern Med. 1994;154(18):2101-2106. doi:10.1001/archinte.1994.00420180111013

Varicella, usually a benign infection of childhood, is known to be associated with more serious complications, especially in adults and immunocompromised patients. Of these, varicella pneumonitis is the most common. Primary varicella hepatitis has been described, though rarely, in immunocompromised patients. We present a case of a previously healthy human immunodeficiency virus—negative 26-year-old immigrant from El Salvador in whom primary varicella developed that rapidly progressed to fulminant hepatic failure, disseminated intravascular coagulation, and death. Autopsy revealed evidence of varicella in the liver, adrenal glands, and myometrium. To our knowledge, this is the first report of a fatal case of varicella hepatitis in a previously healthy, immunocompetent patient.

(Arch Intern Med. 1994;154:2101-2106)