Case report highlights unusual gastrointestinal involvement of varicella-zoster virus in immunocompromised patients under infliximab treatment, suggesting urgent antiviral intervention.
Varicella-zoster virus (VZV) reactivation in immunocompromised patients may present atypically, including with severe gastrointestinal involvement. We present a case of a 36-year-old male with ileocolic Crohn’s disease, who, following Infliximab (IFX) therapy, developed severe gastrointestinal symptoms. Subsequent investigations confirmed a disseminated VZV infection with esophagogastric and duodenal involvement. Our case highlights the crucial need for heightened clinical awareness regarding unusual VZV presentations in immunocompromised patients, especially those receiving TNF- α inhibitors such as Infliximab, known to increase the risk of VZV reactivation. Given the potentially high mortality rate (approximately 40%) associated with gastrointestinal VZV involvement, prompt and aggressive antiviral treatment is imperative.
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Hamraoui et al. (2025) studied this question.
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