Presentación clínica infrecuente de infección por VVZ en un paciente inmunocompetente Infrequent clinical outbreak of VZV in an immunocompetent patient

Summary We present a male patient, 49 year old, that had a chronic alcoholism and a malnourished condition. The patient developed a skin VZV infection characterised by disseminated bullous and haemorrhagic lesions similar to those observed in immune-compromised hosts. When hospitalized, he had a severe metabolic impairment with a negative protein balance secondary to his nutritional status. Treatment included antiviral therapy, intravenous nutrition and metilprednisolone pulse. There was an early and quick improvement of the skin lesions and a complete recovery of the nutritional status in one month. Malnutrition and alcoholism are related conditions, and both of them can cause impaired immune responses. This was not the case in our patient where a complete remission of the viral infection and the favourable evolution of the metabolic syndrome occurred. The case is interesting due to the rare clinical picture induced by the VZV infection in a non immune-compromised host that clinically mimicked this state.