Abstract
Introduction Opportunistic infections are a common cause of morbidity and mortality in patients with CLL. Dermatomal reactivation of the varicella zoster virus is seen in nearly half of patients undergoing treatment with fludarabine. Visceral involvement of varicella, however, is rare and likely marks severely dysfunctional cellular immunity. Visceral varicella has been reported in patients receiving high dose chemotherapy, cyclophosphamide, and rituximab. Here we report the first case of visceral varicella in a patient with CLL during fludarabine therapy. Immunosuppression associated with malignancy and its treatment can lead to infectious complications. Prompt diagnosis in the immunosuppressed patient requires recognition that common illnesses can have uncommon presentations. Opportunistic infections are often seen in patients receiving high dose chemotherapy but are less fre-
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