Case Study: Existing data shows high degree of virulence and frequent need of hospitalization in varicella infection in transplant recipients. Here we present two cases of varicella infection with different outcomes Case 1: 26-year male, a live ABO compatible renal transplant recipient (Basiliximab induction), presented in emergency after one month of transplant with severe pain in abdomen for last 3 days; oral ulcers, erythematous rash on chest for last 2 days. There was no fever or oliguria. The patient was on tacrolimus of 2.0 mg BD, mycophenolate Mofetil (MMF)1gm BD, prednisolone 20 mg OD. His serum and vesicular fluid were positive for VZV by RT-PCR. MMF was stopped and he was treated with Inj. acyclovir 10 mg/kg 8 hourly for 10 days followed by oral therapy to which he responded well. He developed complications like hepatitis and thrombocytopenia which gradually improved (Table 1). Twelve days after discharge he was readmitted with deteriorating sensorium. CSF examination showed TLC of 300 cells, P30L70; protein- 91.7 mg/dl; sugar- 84mg/dl. After 2 days of hospitalization, his sensorium further worsened. CT scan of head showed intracerebral haemorrhage. (Figure 1) He was intubated and died of multiorgan failure after 7 days. Case 2: 33-year male, a live ABO compatible renal transplant recipient (Basiliximab induction), after 3 months of transplant presented with low grade continuous fever and generalised body ache for 4 days; pain in abdomen, rash over face and trunk for last 2 days. The patient was on tacrolimus 2 mg BD, mycophenolate Mofetil 500 mg TDS, prednisolone 7.5 mg OD On examination there was generalized vesicular rash. His investigations revealed thrombocytopenia, transaminitis and vesicular fluid positive for VZV. MMF was stopped and he was started on inj acyclovir 10 mg/kg 8 hourly for 8 days followed by oral therapy for another two weeks. He gradually improved