Chickenpox in adults – Clinical management

Tunbridge, A.; Breuer, Judith; Jeffery, Katie

doi:10.1016/j.jinf.2008.03.004

Cited by 93 publications

(80 citation statements)

References 43 publications

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“…Symptoms and signs of varicella pneumonia appear one to six days after the appearance of skin lesions (6). Patients have the symptoms including cough, hemoptysis, chest pain, dyspnea, while severe cases may have respiratory insufficiency and cyanosis (1,6). In our case, www.respircase.com symptoms of cough, fever, chest pain and dyspnea also occurred four days after the appearance of skin eruptions.…”

Section: Discussionmentioning

confidence: 58%

“…There is nothing in her anamnesis that can cause immune deficiency such as chronic disease, malignancy, chronic use of drug and etc. Symptoms and signs of varicella pneumonia appear one to six days after the appearance of skin lesions (6). Patients have the symptoms including cough, hemoptysis, chest pain, dyspnea, while severe cases may have respiratory insufficiency and cyanosis (1,6).…”

Section: Discussionmentioning

confidence: 99%

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A Case of Respiratory Failure due to Smallpox Pneumonia

Başaran¹,

Gayaf²,

Özsöz³

et al. 2015

Respir Case Rep

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Smallpox pneumonia is a rare complication of the smallpox infection. We present our case of required mechanical ventilation related to smallpox pneumonia in association with respiration failure. A 31-yearold female applied to our emergency department due to cough, tachypnea, and a common papulovesicular skin rash as her radiological investigations bilateral nodular pulmonary infiltrates were diagnosed. She had a contact history, with her baby experiencing the smallpox disease. According to clinical and laboratory findings the case was diagnosed as smallpox pneumonia. Acyclovir 4 gr/day p.o. antiviral management was initiated. At the second day severe dyspnea and cyanoses occurred and patient transferred to intensive care unit after intubation. After 48 hours with mechanical ventilation the patient extubated herself. After 15 days of acyclovir treatment a remarkable clinical and radiological recovery was observed. During smallpox disease symptoms of pneumonia and also possible hypoxemia must be closely monitored in order to prevent mortality due to respiratory failure. Key words: Pneumonia, respiratory failure, smallpox.Smallpox is an infectious disease caused by the varicella zoster virus. It is more commonly encountered during childhood and characterized with fever and skin rush. Smallpox pneumonia is one of the most severe complications of smallpox infection that is experienced during adolescence and Suçiçeği pnömonisi bu hastalığın seyri sırasında görü-lebilen nadir bir durumdur. Burada suçiçeği pnömo-nisi sonrası mekanik ventilasyon gerektiren ciddi bir solunum yetmezliği gelişmiş bir olguyu sunmaya çalıştık. Otuz bir yaşında kadın hasta, hastanemizin acil servisine öksürük, apne, takipne ve yaygın papü-loveziküler döküntü bulgularıyla başvurdu. Radyolojik incelemelerde bilateral nodüler dolgunluk izlendi. Hikâyesinde suçiçeği geçiren bebeği ile teması olduğunu anlattı. Klinik ve laboratuvar bulguları ile hastaya suçiçeği pnömonisi tanısı kondu. Hasta yatırılarak asiklovir 4 gr/gün tedavisi başlandı. Yatışının 2. gü-nünde ciddi dispne ve siyanoz bulguları gelişmesi üzerine entübe edilerek yoğun bakım ünitesine alındı. Mekanik ventilasyon ile 48 saat tedavi sonrası hasta kendini ekstübe etti. Asiklovir tedavisi ile 15 gün sonra belirgin klinik ve radyolojik düzelme sağlandı. Suçiçeği hastalarında görülen pnömoni, gelişebilecek hipoksemi ve solunum yetmezliğine bağlı ölüm ihtimaline karşı yakından takip edilmelidir.Anahtar Sözcükler: Pnömoni, solunum yetmezliği, suçiçeği.may be correlated with death due to respiratory failure (1). In adults, smallpox pneumonia prevalence remains in the range of 0.25-1.8 %. In the most of the cases cough, fever, dyspnea, and tachypnea are the most common symptoms (1,2).

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Section: Discussionmentioning

confidence: 58%

Section: Discussionmentioning

confidence: 99%

A Case of Respiratory Failure due to Smallpox Pneumonia

Başaran¹,

Gayaf²,

Özsöz³

et al. 2015

Respir Case Rep

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“…However, it is increasingly common in adults and adolescents who together with immunosuppressed individuals are at a high risk of severe infection with involvement of different organ systems. 6 It is generally more severe in adult men than in women or children. Pregnant women, smokers, old people with a weak immune system, people with HIV, those on steroids and chemotherapy are more vulnerable.…”

Section: Discussionmentioning

confidence: 99%

Coagulopathy secondary to chicken pox: a case report

et al. 2017

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Chickenpox often produces a self-limiting disease in children and adolescents. The clinical course is usually mild and complications are rare. The complications that are known to be associated with it are pneumonia, meningitis, myocarditis and nephritis. Severe and disseminated varicella infection with organ dysfunction can also be seen amongst diabetics and immunocompromised patients. However, it is not commonly known that varicella can be life threatening even in immunocompetent adult patients. We present a case of a healthy adult male in which this infection progressed to malignant hemorrhagic disease associated with coagulopathy.

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“…Consequently, it has been suggested as prophylaxis in pregnant women (especially if VZIGs are not available) [169] , particularly if administered within seven days of exposure and within 24 h of the onset of the rash [26,54,252,265,266] . The use of acyclovir during pregnancy has been widely debated in the literature: There is general consensus concerning its use when the mother's life is in danger and as a means of reducing the severity of complications occurring in late pregnancy [19,53,151,156,256,267] , but its therapeutic and CVS prophylactic use before the twentieth week of gestation is more controversial; some authors favour its administration always, and others only after 20 wk [10,16,19,53,54,151,156,169,252,256,[267][268][269][270][271] . As the virus crosses the placenta during both viremic phases of incubation, the second of which seems to play a greater role in fetal transmission, it has been suggested that secondary viremia can be prevented or minimised by acyclovir provided that it is not given too early [21,22,26,265] .…”

Section: Therapymentioning

confidence: 99%

Microbiology laboratory and the management of mother-child varicella-zoster virus infection

Paschale

Clerici

2016

WJV

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Varicella-zoster virus, which is responsible for varicella (chickenpox) and herpes zoster (shingles), is ubiquitous and causes an acute infection among children, especially those aged less than six years. As 90% of adults have had varicella in childhood, it is unusual to encounter an infected pregnant woman but, if the disease does appear, it can lead to complications for both the mother and fetus or newborn. The major maternal complications include pneumonia, which can lead to death if not treated. If the virus passes to the fetus, congenital varicella syndrome, neonatal varicella (particularly serious if maternal rash appears in the days immediately before or after childbirth) or herpes zoster in the early years of life may occur depending on the time of infection. A Microbiology laboratory can help in the diagnosis and management of mother-child infection at four main times: (1) when a pregnant woman has been exposed to varicella or herpes zoster, a prompt search for specific antibodies can determine whether she is susceptible to, or protected against infection; (2) when a pregnant woman develops clinical symptoms consistent with varicella, the diagnosis is usually clinical, but a laboratory can be crucial if the symptoms are doubtful or otherwise unclear (atypical patterns in immunocompromised subjects, patients with post-vaccination varicella, or subjects who have received immunoglobulins), or if there is a need for a differential diagnosis between varicella and other types of dermatoses with vesicle formation; (3) when a prenatal diagnosis of uterine infection is required in order to detect cases of congenital varicella syndrome after the onset of varicella in the mother; and (4) when the baby is born and it is necessary to confirm a diagnosis of varicella (and its complications), make a differential diagnosis between varicella and other diseases with similar symptoms, or confirm a causal relationship between maternal varicella and malformations in a newborn. Core tip: Although varicella during pregnancy is infrequent and congenital varicella syndrome (CVS) is rare, every available means should be used to prevent and diagnose them. Microbiology laboratories can be crucial in these situations: Evaluating a mother's immune status with sensitive and specific tests for the detection of antibodies; allowing a rapid diagnosis with molecular biology tests when a clinical manifestation may be due to different etiologies; following pregnant women with varicella for the prenatal diagnosis of CVS with close collaboration between molecular biology investigators and specialists in imaging diagnostics.De Paschale M, Clerici P. Microbiology laboratory and the management of mother-child varicella-zoster virus infection. World

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Chickenpox in adults – Clinical management

Cited by 93 publications

References 43 publications

A Case of Respiratory Failure due to Smallpox Pneumonia

A Case of Respiratory Failure due to Smallpox Pneumonia

Coagulopathy secondary to chicken pox: a case report

Microbiology laboratory and the management of mother-child varicella-zoster virus infection

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