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.