Adult Primary Varicella Pneumonia: High-resolution Computed Tomography Findings

Abstract

A 73-year-old woman was hospitalized for the treatment of anaplastic large-cell lymphoma. She complained of itchiness with a rash on her trunk and was diagnosed with chickenpox. Although she had no respiratory symptoms, chest high-resolution computed tomography (HRCT) performed on the same day showed multiple nodules with surrounding ground-glass attenuation (GGA) and consolidation (Picture). Bronchoscopy was performed to diagnose the lung involvement. The histopathological features of the specimens obtained via a transbronchial lung biopsy were nonspecific. An examination of the bronchoalveolar lavage (BAL) fluid demonstrated a total cell count of 229/μL, with the differential count showing 52% lymphocytes, 2% neutrophils, 1% eosinophils and 45% alveolar macrophages, while the ratio of CD4/8 was 1.75. Varicella-zoster viral DNA was detected in the BAL fluid (90×10 6 copy/mL), although no findings caused by other lung diseases were found. Therefore, the patient was diagnosed with primary varicella pneumonia.

The Efficacy of Amenamevir for the Treatment of Disseminated Herpes Zoster Complicated with Probable Varicella-zoster Pneumonia in an Immunocompromised Patient

“…2 ). These findings were comparable to those associated with varicella-zoster pneumonia ( 9 , 10 ). Since bronchoalveolar lavage fluid test findings were unavailable, it could not be ruled out that the cause of the new lung involvement was something other than a VZV infection, such as an exacerbation of existing interstitial pneumonia due to MPA at that time.…”

Assesment of Pediatric Varicella Pneumonia

“…In these patients, high resolution computed tomography (HRCT) is an alternative for diagnosis. The HRCT findings of varicella pneumonia have been previously reported, including small, well-defined and ill-defined nodules, centrilobular nodules, nodules with surrounding ground-glass attenuation, patchy ground-glass attenuation and coalescence of nodules (10,11). In our study, eight patients had reticular and five patients had reticulonodular densities in chest radiography which are characteristic in varicella pneumonia.…”

Healed Varicella Pneumonia: A Case of Diffuse Pulmonary Microcalcifications

“…Varicella pneumonia can be diagnosed utilizing bronchoalveolar lavage, which checks for the presence of varicella-zoster viral DNA via polymerase chain reaction (PCR) [ 15 ]. Previous case reports have used skin biopsies to test for VZV if the patient presented with a vesicular-pustular rash.…”

“…Treatment for patients presenting with Varicella pneumonia would be to begin IV acyclovir with intensive supportive care [ 15 , 16 ]. The use of steroids as part of the treatment regimen remains controversial, yet a multitude of case reports have included steroids as part of care management [ 17 , 18 ].…”