Varicella Pneumonia in an Immunocompetent Adult

Excerpt

A previously healthy 37-year-old man presented with fever, nonproductive cough, and 2 days of diffuse rash that started on his chest. He denied dyspnea. He had never received the chickenpox vaccine. Physical examination revealed vesicular lesions of various stages on the trunk, neck (Image 1), head, and extremities. Chest radiograph revealed bilateral patchy opacities, and a CT scan of the chest (Image 2) showed diffuse ground-glass opacities. The patient was treated with intravenous acyclovir for severe chickenpox (varicella-zoster virus), which was subsequently confirmed on vesicular fluid PCR. Human immunodeficiency virus testing was negative. On hospital day two, he developed respiratory failure requiring mechanical ventilation for 5 days. He had a full recovery and was discharged with a 10-day course of oral acyclovir.

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