Visceral zoster as the presenting feature of disseminated herpes zoster.

Visceral dissemination of herpes zoster may follow cutaneous dissemination in immunocompromised patients. The skin is not necessarily the only organ affected and may not even be the presenting organ. Immunohistochemical stains available for routine paraffin-embedded tissue biopsy specimens allow for rapid diagnosis of varicella zoster virus. We describe a patient in whom gastric dissemination of herpes zoster was proven by immunohistochemistry. Unexplained hepatitis, pancreatitis, gastritis, or complaints of abdominal pain in immunocompromised patients with herpes zoster should prompt a high degree of suspicion for visceral zoster and immediate treatment with intravenous acyclovir.