DOI: 10.12890/2026_006229

Disseminated visceral varicella presenting as gastric ulcers

Authors

  • Coana Sukmagautama Department of Internal Medicine, Universitas Sebelas Maret Hospital, Surakarta, Indonesia
  • Christopher William Purnomo Disease Control Research Group, Universitas Sebelas Maret, Surakarta, Indonesia; Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia 0000-0003-2436-3300
  • Kenneth Tan Disease Control Research Group, Universitas Sebelas Maret, Surakarta, Indonesia
  • Alya Amelia Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia
  • Alifa el Husna Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia

christopherwilly28@gmail.com

Keywords

Varicella Zoster Virus, Disseminated Varicella, Gastric Ulcer, Immunocompromised Host, Herpes Zoster

Abstract

Introduction: Herpes zoster results from reactivation of varicella-zoster virus (VZV) and classically presents with a dermatomal vesicular rash. Disseminated or visceral involvement is uncommon and predominantly occurs in immunosuppressed individuals. Gastrointestinal manifestations, such as oesophageal or gastric ulceration, are rare and can lead to diagnostic delay due to their non-specific presentation.
Case description: We report the case of 70-year-old man presenting with progressive dysphagia and weight loss over four weeks. The symptoms were preceded by dermatomal facial vesicular lesions consistent with herpes zoster, followed by the appearance of non-dermatomal cutaneous lesions. The patient had underlying type 2 diabetes mellitus and was geriatric, constituting functional immunosuppression. Upper gastrointestinal endoscopy revealed multiple ulcerations in the oesophagus and gastric antrum. Histopathology examination demonstrated viral cytopathic changes compatible with VZV infection, supporting a diagnosis of disseminated visceral varicella. Due to limited antiviral availability, the patient was managed with supportive therapy, systemic corticosteroids and symptomatic treatment, resulting in significant clinical improvement and resolution of dysphagia.
Conclusion: This case highlights disseminated visceral varicella as an important but under-recognised cause of gastrointestinal ulcerations in immunosuppressed elderly patients. Establishing standardised reporting criteria would allow for more persistent comparison and analysis of this rare manifestation of varicella infection.

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Published

2026-02-24

Issue

Vol. 13 No. 3 (2026)

Categories

How to Cite

1.
Sukmagautama C, Purnomo CW, Tan K, Amelia A, el Husna A. Disseminated visceral varicella presenting as gastric ulcers. EJCRIM [Internet]. 2026 Feb. 24 [cited 2026 Nov. 3];13(3). Available from: https://ejcrim.com/index.php/ejcrim/article/view/6229