Herpes Zoster surgery, Herpes Zoster virology, Herpesvirus 3, Human genetics, Herpesvirus 3, Human isolation purification, Humans, Male, Splenectomy, Splenic Rupture surgery, Young Adult, Herpes Zoster diagnosis, and Splenic Rupture virology

A 22-year-old man presented with a 1-day history of severe abdominal pain. He developed a generalised vesicular rash 12 h prior to admission. On examination, he was maximally tender with peritonism in the lower abdomen. Working diagnosis was perforated appendix and a decision to investigate with CT was made, which showed intra-abdominal haemorrhage likely arising from a ruptured spleen. After a period of observation, he subsequently underwent laparotomy and emergency splenectomy. Viral PCR from vesicular fluid was positive for varicella zoster virus. Viral serology was otherwise negative.
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