55yo F s/p renal transplant who presents with 3 months of whole body rash found to have disseminated cutaneous VZV
Dr. Marcus Pereira | Morning Report | 07/05/2017
Immunosupressed patients who present with diffuse rash has broad differential. Think: VZV, HSV, coxsackie, mycobacterium, actinomyces, cryptococcus (usually not vesicular, more nodular), histoplasmosis, sporotrichosis (usually lymphatic spread confined to one limb).
Posted 07/05/17 10:24:09 AM by Emily Miller
Disseminated viral infection - look for atypical lymphocytes of CBC differential. Helpful, but not diagnostic.
Posted 07/05/17 10:24:51 AM by Emily Miller
Tzanck smear can be helpful in narrowing differential if multinucleated giant cells are present. However, cannot differentiate between VZV and HSV.
Posted 07/05/17 10:35:54 AM by Emily Miller
Acyclovir does not treat CMV, but ganciclovir does treat VZV. Think of Ganciclovir is the broad spectrum herpesvirus antiviral.