Year: 2013
Type: article
Study design: Case Report
Abstract: A 35-year old man presented to the emergency room with sudden onset of fever, dyspnoea, bilateral pleuritic thoracalgy, and an exanthematous vesicular rash.He was a smoker and his two year-old son had chickenpox two weeks earlier.The patient had no previous immunization or known contact with the disease.On examination, he was febrile (39º C) with signs of respiratory distress (oxygen saturation of 88% on room air).An extensive polymorphic pruritic rash with macular, vesicles, pustules and crusty lesions was noticed (Fig. 1).Laboratory studies showed mild thrombocytopenia and elevation of liver enzymes (AST, ALT, GGT) and lactate dehydrogenese (LDH).Chest X-ray revealed multinodular interstitial infiltrates in both lungs (Fig. 2).Arterial blood gases were consistent with hypoxemic respiratory failure (PaO 2 of 51.8 mmHg).HIV testing was negative.The diagnosis of varicella pneumonia with mild liver involvement on an immunocompetent patient was made and supportive treatment and intravenous acyclovir (10 mg/kg every 8 h) was promptly initiated.Excellent clinical and radiological evolution was documented, as was analytical normalization.After one week of therapy, the patient was discharged fully recovered.Varicella pneumonia has an approximate incidence of 1:400 cases, being the main cause of morbility and mortality reaching up to 50 per cent in patients requiring mechanical ventilation 1,2 .Male gender 2 and tobacco
Source: PubMed Central
Authors: Goncalo Marto, Sofia Nunes
Institution: Centro Hospitalar do Baixo Vouga
Language: English
Subfield: Infectious Diseases
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W2199832448