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Abstract
Varicella, more commonly known as chickenpox, is caused by the varicella-zoster virus. It is a common benign childhood illness. In adults, Varicella is uncommon but is more severely associated with complications including pneumonia, hepatitis, disseminated intravascular coagulation, encephalitis and myocarditis. A serious and life-threatening complication is the development of varicella-zoster virus pneumonia (VZVP). Although VZVP is well described in immunocompromised hosts, it is rarely seen in immunocompetent adults. The VZVP in healthy adults is more prevalent in cigarette smokers and during pregnancy. However, reports of VZVP in healthy adults are scarce in Korea. The authors report here a case of VZVP in an immunocompetent adult and present a literature review.
Figures and Tables
Figure 2
(A) The simple chest radiography shows multiple small nodules in both lungs. (B) After 3 weeks, the size and number of the nodules have decreased.
Figure 3
(A) Chest computed tomography scan shows multiple 5~10 mm sized nodules with ground glass opacities scatterd in both lung fields. (B) After 3 weeks, the nodules have decreased and the ground glass opacities have disappeared.
Figure 4
In bronchoscopic findings, multiple whitish plaques appear at the carina (A), and right bronchus intermedius (B).
Figure 5
Bronchial biopsy is performed at the whitish plaque. (A) The bronchial mucosa reveals extensive necrosis and regeneration of surface metaplastic squamous epithelium (H&E, ×200). Transbronchial lung biopsy is performed. (B) Hemorrhages appear surrounding the inflammatory cells and multifocal interstitial fibrosis can be seen (H&E, ×200).
References
1. Gregorakos L, Myrianthefs P, Markou N, Chroni D, Sakagianni E. Severity of illness and outcome in adult patients with primary varicella pneumonia. Respiration. 2002. 69:330–334.
2. Mohsen AH, McKendrick M. Varicella pneumonia in adults. Eur Respir J. 2003. 21:886–891.
3. Jones AM, Thomas N, Wilkins EG. Outcome of varicella pneumonitis in immunocompetent adults requiring treatment in a high dependency unit. J Infect. 2001. 43:135–139.
4. Haake DA, Zakowski PC, Haake DL, Bryson YJ. Early treatment with acyclovir for varicella pneumonia in otherwise healthy adults: retrospective controlled study and review. Rev Infect Dis. 1990. 12:788–798.
5. Shin YM, Moon SK, Kim CW, Shin DH, Choi JS, Kim KH. A case of varicella pneumonia in healthy adult. Korean J Dermatol. 2007. 45:394–396.
6. Kim JS, Ryu CW, Lee SI, Sung DW, Park CK. High-resolution CT findings of varicella-zoster pneumonia. AJR Am J Roentgenol. 1999. 172:113–116.
7. Pugh RN, Omar RI, Hossain MM. Varicella infection and pneumonia among adults. Int J Infect Dis. 1998. 2:205–210.
8. Mohsen AH, Peck RJ, Mason Z, Mattock L, McKendrick MW. Lung function tests and risk factors for pneumonia in adults with chickenpox. Thorax. 2001. 56:796–799.
9. Wallace MR, Bowler WA, Oldfield EC 3rd. Treatment of varicella in the immunocompetent adult. J Med Virol. 1993. Suppl 1. 90–92.
10. Nilsson A, Ortqvist A. Severe varicella pneumonia in adults in Stockholm County 1980-1989. Scand J Infect Dis. 1996. 28:121–123.
11. Mer M, Richards GA. Corticosteroids in life-threatening varicella pneumonia. Chest. 1998. 114:426–431.
12. Cowl CT, Prakash UB, Shawn Mitchell P, Migden MR. Varicella-zoster virus detection by polymerase chain reaction using bronchoalveolar lavage specimens. Am J Respir Crit Care Med. 2000. 162:753–754.
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