Abstract
BACKGROUND: Varicella zoster virus (VZV) infection in adults can lead to severe complications, particularly in those with underlying comorbidities. This case report presents a rare instance of VZV-associated fulminant hepatitis progressing to multi-organ failure in a 27-year-old female with glucose-6-phosphate dehydrogenase (G6PD) deficiency. CASE PRESENTATION: The patient presented with a generalized rash and rapidly developed acute liver failure, coagulopathy, and renal dysfunction. Despite aggressive management, including intravenous immunoglobulin therapy and supportive care, the patient's condition deteriorated, ultimately resulting in mortality. CONCLUSIONS: This case highlights the potential for severe hepatic complications in adult VZV infections, especially in patients with G6PD deficiency, and underscores the importance of early recognition and aggressive management. It also raises awareness about the risks associated with concomitant medication use, including over-the-counter drugs and herbal supplements, in the context of acute viral infections. CLINICAL TRIAL NUMBER: Not applicable.