Varicella Zoster Infection Under Valganciclovir Prophylaxis After Renal Transplantation

Intensive immunosuppressive therapy in renal transplant patients increases the risk for infectious diseases. Varicella zoster virus (VZV) infection is one of these infectious diseases and can occur either primarily or with reactivation of latent disease with disseminated skin lesions or visceral involvement. Mortality rate due to disseminated VZV infection is as high as 30%. Valacyclovir and valganciclovir, which are wide spectrum antiherpetic agents used for cytomegalovirus (CMV) prophylaxis, act against not only CMV but also herpes simplex virus (HSV) and VZV. We describe a patient who did not have a VZV infection history in childhood and suffered from disseminated VZV infection with skin, liver and left eye involvement 5½ months after renal transplantation under valgancyclovir prophilaxis for CMV, and discuss the management of primary VZV infection.