Triad of Severe Abdominal Pain, Inappropriate Antidiuretic Hormone Secretion, and Disseminated Varicella-Zoster Virus Infection Preceding Cutaneous Manifestations After Hematopoietic Stem Cell Transplantation: Utility of PCR for Early Recognition and Therapy

A hematopoietic stem cell transplant recipient developed abdominal pain, pneumatosis intestinalis, hepatitis, pancreatitis, and inappropriate antidiuretic hormone secretion. Blood for varicella-zoster virus (VZV) DNA polymerase chain reaction was positive. She was treated with acyclovir and subsequently developed VZV antigen-positive zoster. Detection of VZV DNA in blood may be useful for early diagnosis in immunocompromised hosts who present with zoster without skin lesions.