Varicella Recurrence Complicated by Pneumonia After Liver Transplantation for APECED

    Akshay Batra, Suzanne Davison, Sanjay Rajwal, Antony Hale, Mark D. Stringer, Patricia McClean
    TLDR A liver transplant patient with APECED had a rare VZV recurrence and pneumonia, treated successfully, but later died from other infections.
    This case report described a 16-year-old boy with autoimmune polyendocrinopathy candidiasis and ectodermal dysplasia (APECED) who experienced a recurrence of varicella zoster virus (VZV) infection complicated by pneumonia after a liver transplant. Despite having had chicken pox and good VZV IgG titers before transplantation, the patient developed pneumonia, which is rare in such cases. The pneumonia was treated successfully with high-dose intravenous acyclovir and steroids, leading to a relatively mild course of illness. The report highlighted the importance of considering VZV in immunocompromised patients with atypical rashes and the need for early treatment. Unfortunately, the patient later died from pneumococcal pneumonia and septicemia.
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