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Reminder of important clinical lesson
A case for varicella vaccination in the immunosuppressed
  1. Michael Vaclav Holmes,
  2. Sowsan F Atabani,
  3. Nasser Khan,
  4. Kate Steiner,
  5. Tanzina Haque,
  6. Gabrielle Slapak
  1. Royal Free Hospital NHS Trust, Pond Street, London NW3 2XA, UK
  1. Michael Vaclav Holmes, mvholmes{at}


A middle-aged man with long-standing Crohn disease maintained in remission on low-dose immunosuppression presented with abdominal pain. Over the following few days he developed a vesicular rash, became dyspnoeic, confused and had two seizures. Despite high-dose intravenous aciclovir, he died. Disseminated varicella zoster virus, the cause of his death, could potentially have been prevented had he received varicella vaccination at an earlier stage.

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  • Competing interests: none.

  • Patient consent: Patient/guardian consent was obtained for publication.

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