{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,25]],"date-time":"2025-10-25T19:08:22Z","timestamp":1761419302389,"version":"3.44.0"},"reference-count":20,"publisher":"BMJ","issue":"3","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2019,3,9]]},"published-print":{"date-parts":[[2019,3]]},"abstract":"<jats:p>The use of immunosuppressing agents can act as a catalyst for viral reactivation, promoting systemic infection with organ involvement. Current literature remains sparse on this topic but does provide individual case reports involving single viruses. We present the case of an immunocompromised patient with skin lesions, pancreatitis, colitis and hepatitis. Work-up revealed varicella zoster virus, which likely put the patient at risk for multi-organ involvement, as well as clinical suspicion of other implicated viruses, specifically herpes simplex virus and cytomegalovirus. A high clinical index of suspicion along with biopsy guidance for viral involvement in immunocompromised patients is crucial for early diagnosis and treatment of these conditions.<\/jats:p>","DOI":"10.1136\/bcr-2018-228150","type":"journal-article","created":{"date-parts":[[2019,4,2]],"date-time":"2019-04-02T05:12:49Z","timestamp":1554181969000},"page":"e228150","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Multi-organ involvement secondary to varicella zoster virus, herpes simplex virus and cytomegalovirus in an immunocompromised patient"],"prefix":"10.1136","volume":"12","author":[{"given":"Ripal","family":"Jariwala","sequence":"first","affiliation":[{"name":"Department of Pharmacy, Tampa General Hospital, Tampa, Florida, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kristen","family":"Zeitler","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Tampa General Hospital, Tampa, Florida, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicole D","family":"Riddle","sequence":"additional","affiliation":[{"name":"USF Pathology, Ruffolo, Hooper and Associates, Tampa, Florida, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chakrapol","family":"Sriaroon","sequence":"additional","affiliation":[{"name":"Division of Pulmonaryand Critical Care Medicine, University of South Florida, Tampa, Florida, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2019,3,31]]},"reference":[{"key":"2025082703372879000_12.3.e228150.1","doi-asserted-by":"crossref","DOI":"10.1097\/MD.0000000000005082","article-title":"Concomitant herpes simplex virus colitis and hepatitis in a man with ulcerative colitis: Case report and review of the literature","volume":"95","author":"Phadke","year":"2016","journal-title":"Medicine"},{"key":"2025082703372879000_12.3.e228150.2","doi-asserted-by":"crossref","first-page":"18053","DOI":"10.3748\/wjg.v20.i47.18053","article-title":"Acute pancreatitis associated with herpes zoster: case report and literature review","volume":"20","author":"Wang","year":"2014","journal-title":"World J Gastroenterol"},{"key":"2025082703372879000_12.3.e228150.3","unstructured":"Corona-Nakamura AL , Arias-Merino MJ . Management of cmv-associated diseases in immunocompromised patients, manifestations of cytomegalovirus infection, patricia price, nandini makwana and samantha brunt, intechopen. https:\/\/www.intechopen.com\/books\/manifestations-of-cytomegalovirus-infection\/management-of-cmv-associated-diseases-in-immunocompromised-patients."},{"key":"2025082703372879000_12.3.e228150.4","unstructured":"Centers for Disease Control and Prevention. 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IgG subclasses and allotypes: from structure to effector functions. 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