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Article in Japanese
A case of unexpected rapid death due to disseminated varicella zoster that developed during treatments for metastatic small cell lung cancer and interstitial lung disease
Minako Omaea Koshi Yokomuraa Takefumi Abea Norimichi Akiyamaa Tsuyoshi Nozuea Takafumi Sudab
aDepartment of Respiratory Medicine, Respiratory Disease Center, Seirei Mikatahara General Hospital
bSecond Division, Department of Internal Medicine, Hamamatsu University School of Medicine
A 76-year-old female with interstitial lung disease (ILD) was diagnosed as metastatic small cell lung cancer in May 20XX and treated with systemic chemotherapy. During the 2nd line treatment, the ILD progressively deteriorated and prednisolone was administered orally by 30 mg/day. After 4 weeks, blisters suddenly erupted on her body with fever elevation, and she died in just one day with multiple organ failure and disseminated intravascular coagulation. Although both specific IgG and IgM for varicella zoster did not elevate in the current case, it was highly suspected to be disseminated varicella zoster infection according to the characteristic skin eruption and surprisingly rapid death. Later, it became apparent that her husband had herpes zoster two weeks before her blisters eruption. Our current case indicates that it could be quite difficult to treat disseminated varicella zoster once developed, and, in addition to our attention, we should bring more patient and family attention to the herpes zoster infection during systemic chemotherapy or immunosuppressive treatments.
Small cell lung cancer Interstitial pneumonia Immunocompromised host Disseminated varicella zoster Herpes zoster
Received 6 Mar 2015 / Accepted 25 May 2015
AJRS, 4(5): 403-407, 2015