Introduction
Cytomegalovirus (CMV) reactivation potentially leads to severe conditions, including retinitis, hepatitis, gastrointestinal ulceration, skin ulcers, and pneumonia 1,2. To prevent these clinical conditions, the reactivation needs to be detected in the early stage. Three cases of CMV reactivation combined with varicella due to the reactivation or reinfection of varicella zoster virus (VZV) in immunocompromised adults have been reported in the English literature in the past 10 years 3-5. Varicella preceded CMV reactivation in all three cases. Based on these findings, varicella is strongly suggested to lead to CMV reactivation in immunocompromised patients. The reactivation or reinfection of VZV was suggested as the developmental mechanism of varicella in the cases reported by Kasuyaet al . 3 and Hioki et al .4, although Qi et al . did not definitively indicate the developmental mechanism of varicella 5. Therefore, it currently remains unclear whether primary infection of VZV is followed by the reactivation of CMV. We encountered a compromised patient with the onset of varicella as primary VZV infection immediately followed by CMV reactivation.