Varicella‐zoster virus replication site in internal organs of an otherwise healthy child with varicella and sudden death

Pathological findings of an otherwise healthy 17 month old boy who was exposed to Varicella‐zoster virus (VZV) in his family and unexpectedly died 3 days after onset of varicella are reported. They showed a disseminated VZV infection with involvement of skin, lung, liver, spleen, gastrointestinal tract and other organs where VZV antigen was detected by the enzyme‐immunoassay with monoclonal antibodies to VZV. Since the subject was the full‐term product of an uncomplicated pregnancy, who grew and developed normally, and had no symptoms or laboratory findings suggestive of immunodeficiency until his death, these findings suggest that many organs are involved as major internal sites of viral replication before or during infection of skin with VZV in the immunocompetent host. 1993 Japan Pediatric Society