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Approximately 4 million cases of varicella-zoster occur annually, most of which are self-limited and managed conservatively with supportive care with or without oral valacyclovir. However, varicella-zoster rarely disseminates leading to severe systemic illness affecting multiple organs. Disseminated varicella-zoster causes significant morbidity and mortality, particularly in immunocompromised individuals. In this study, we report a case of a 27-year-old immunosuppressed man who developed disseminated varicella-zoster infection culminating in multiorgan failure and death. We review the epidemiology, risk factors, diagnosis, prevention, and treatment of disseminated varicella-zoster., (© 2025 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of The American College of Gastroenterology.)

Hemophagocytic lymphohistiocytosis (HLH) is a syndrome of excessive immune activation that mimics and occurs with other systemic diseases. A 35-year-old female presented with signs of viral illness at 13 weeks of pregnancy and progressed to acute liver failure (ALF). We discuss the diagnosis of HLH and Kikuchi-Fujimoto (KF) lymphadenitis in the context of pregnancy and ALF. HLH may respond to comorbid disease-specific therapy, and more toxic treatment can be avoided.