Fulminant Varicella Hepatitis Following Bone Marrow Transplantation

To the Editor.— As the cases of bone marrow transplantation (BMT) are accumulating, viral infection such as cytomegalovirus emerges as one of the major problems. 1 However, other viral agents should not be ignored since infection is sometimes fatal if visceral dissemination occurs. In varicella zoster virus (VZV) infection, death caused by encephalitis or interstitial pneumonitis has been reported. 2 Recently, we have experienced a rare case of VZV infection terminating in fulminant hepatitis associated with disseminated intravascular coagulation. Report of a Case.— A 40-year-old Japanese man was diagnosed as having acute myeloblastic leukemia (M2 in the French-American-British cooperative group classification). Complete remission was obtained by two courses of chemotherapy with daunorubicin, cytarabine, mercaptopurine, and prednisolone, but six months after diagnosis, he relapsed with CNS involvement. A second complete remission was obtained following two courses of chemotherapy with benzoyl-cytarabine, aclarubicin, mercaptopurine, and prednisolone and intrathecal methotrexate infusion, and BMT from