BMJ Case Reports 2016; doi:10.1136/bcr-2015-212688

Fatal disseminated varicella zoster infection following zoster vaccination in an immunocompromised patient

  1. I Johannessen1
  1. 1Royal Infirmary of Edinburgh, Edinburgh, UK
  2. 2Borders General Hospital, Melrose, UK
  3. 3Great Ormond St Hospital for Children, London, UK
  4. 4Department of Medical Virology, Royal Infirmary of Edinburgh, Edinburgh, UK
  1. Correspondence to KE Templeton, Kate.Templeton{at}
  • Accepted 11 April 2016
  • Published 4 May 2016


A 79-year-old man with chronic lymphocytic leukaemia presented with fever and a widespread vesicular rash on 19 November 2014. The patient had not been under immunosuppressive regime for 6 months. He had received a shingles vaccine on 14th October and developed flu-like symptoms after 2 weeks. Intravenous antimicrobial therapy including aciclovir was started. He remained stable with no evidence of systemic involvement. On day 5, he developed respiratory and renal failure that required transfer to intensive care unit. Vesicle fluid, bronchoalveolar lavage and plasma were positive for varicella zoster virus by PCR. Slight clinical improvement allowed extubation on day 16. He subsequently deteriorated and died on day 25. Multiorgan failure was considered the immediate cause of death whereas disseminated varicella zoster infection was stated in the medical certificate as the other condition leading to this outcome. Varicella zoster Oka vaccine strain was detected in vesicle fluid, using PCR.

Register for free content

The full text of all Editor's Choice articles and summaries of every article are free without registration

The full text of Images in ... articles are free to registered users

Only fellows can access the full text of case reports (apart from Editor's Choice) - become a fellow today, or encourage your institution to, so that together we can grow and develop this resource

Don't forget to sign up for content alerts so you keep up to date with all the case reports as they are published, and let us know what you think by commenting on the Editor's blog

Navigate This Article