Varicella Pneumonia in a Healthy Adult: Case Report

Alkan Ceviker S., Gunal O.



Varicella virus infection is a highly contagious, mild, rash viral disease often seen in childhood. In adult age, it is more severe and complicated. In adults, the most common life-threatening complication is varicella pneumonia. A 31-year-old male patient was admitted to the emergency department on the 5th day of onset of rash on his back and all-body rash and on the development of complaints of high fever, chills, widespread chest pain, drowsiness and coughing during the last 2 days. Physical examination revealed tachypnea and there were maculopapular and vesicular lesions on his whole body. He was a smoker and his child had suffered from chickenpox, two weeks earlier. The eyelids were edematous, the conjunctive were hyperemic and the oropharynx and tonsils were normal. Pulmonary auscultation revealed bilateral crackles. On examination, he was febrile (38.5 degrees C), heart rate was 120 beats/min, arterial blood pressure was 100/60 mmHg and oxygen saturation was 88%. In laboratory examinations; leukocyte count: 7300/mu L (49% PNL, 37% lymphocytes, 13% monocytes), platelet count: 83.000/mm(3) , C-reactive protein: 15.7 mg/L, erythrocyte sedimentation rate: 13 mm/hour, blood sugar: 91 mg/dL, urea: 26 mg/dL, creatinine: 0.6 mg/dL, ALT: 112 U/L, AST 151 U/L, ALP: 244 U/L, GGT: 414 U/L, LDH: 4400 U/L, and HBsAg, anti-HBs, anti-HCV and anti-HIV were negative. A diffuse, poorly defined, bilateral alveolar-interstitial opacities were detected on her chest X-ray. Treatment with ampicillin-sulbactam (1 g IV 4 times a day) + acyclovir (3 x 10 mg/kg/day IV) was initiated empirically with varicella pneumonia plus seconder bacterial pneumonia. Varicella IgM was positive and Varicella IgG were negative in the patient's tests. On the 10th day of the patients treatment, he was discharged by cure after he recovery his laboratory and clinical findings. As a result; it is once again understood how important vaccination for vaccine-preventable infections is, and care should be taken in terms of viral infections with rash and the complications that may arise therefrom.