Abstract
Although rarely observed, varicella zoster virus (VZV)-related pneumonia is the most serious complication of the virus, which commonly affects adults and causes high mortality rates. In this study, we describe a case of VZV pneumonia in a 29-year-old male who is an inactive Hepatitis B virus carrier. The patient presented with a 5-day history of fatigue, sore throat, fever, cough and mild dyspnea. He also had an exanthematous vesicular rash. The rash had spread all over his body surface including the hairy skin. But he was not febrile and vital signs were normal. The skin examination exhibited a diffuse polymorphic rash with papules/vesicles, pustules and crusty lesions over the whole body. Serological findings were as follows: VZV IgM positive, VZV IgG positive and HBsAg positive. His chest X-ray showed bilateral pneumonic infiltrations. The patient was prescribed valacyclovir and clarithromycin. The skin lesions disappeared after ten days and the patient made a full recovery. We conclude that an early diagnosis of VZV pneumonia, which rarely occurs in adult patients and its effective treatment with antivirals may prevent the development of serious complications.
Keywords
References
- Curry MP, Chopra S. Acute Viral Hepatitis. In: Mandell GL, Bennett JE, Dolin R, (eds). Principles and Practice of Infectious Diseases. 7th ed. Philadelphia: Churchill Livingstone; 2010:1577-1592.
- Perz JF, Armstrong GL, Farrington LA, Hutin YJ, Bell BP. The contribution of hepatitis B and hepatitis C virus infection to cirrhosis and primary liver cancer worldwide. J Hepatol 2006; 45:529-538.
- Tong MJ, Hsu LY, Chang PW, Blatt LM. Evaluation of current treatment recommendations for chronic hepatitis B: a 2011 update. J Gastroenterol Hepatol 2011; 26:829-835.
- Rizzetto M, Ciancio A. Chronic HBV-related liver disease. Mol Aspects Med 2008;29:72-84.
- Jung MC, Pape GR. Immunology of hepatitis B infection. Lancet Infect Dis 2002; 2:43-50.
- Dengming He, Guohua Yan, Wang Y. Serum levels of interleukin-12 in various clinical states with hepatitis B virus infection. Cell Immunol 2012; 272:162-165.
- Megged O, Schlesinger Y. Varicella zoster infection in adults: a preventable disease. Isr Med Assoc J 2009; 11:306-307.
- Monaghan TM, Norton B. Varicella pneumonia in an immunocompromised inflammatory bowel disease patient. Inflamm Bowel Dis 2010;16:364-365.
- Sato A, Amada N, Kikuchi H, Fukumori T, Haga I, Takahashi Y. Pneumonia due to varicella-zoster virus reinfection in a renal transplant recipient. Transplant Proc 2009;41:3959-3961.
- Mohsen AH, McKendrick M. Varicella pneumonia in adults. Eur Respir J 2003;21:886-891.
- Gregorakos L, Myrianthefs P, Markou N, Chroni D, Sakagianni E. Severity of illness and outcome in adult patients with primary varicella pneumonia. Respiration 2002;69:330-334.
- Tunbridge AJ, Breuer J, Jeffery KJ. Chickenpox in adultsclinical management. J Infect 2008;57:95-102.
- Rehermann B. Chronic infections with hepatotropic viruses: mechanisms of impairment of cellular immune responses. Semin Liver Dis 2007; 27:152-160.
- Feldman S. Varicella-zoster virus pneumonitis. Chest 1994; 106 (Suppl 1):22-27.
- McCrary ML, Severson J, Tyring SK. Varicella zoster virus. J Am Acad Dermatol 1999; 41:1-14.
- Heininger U, Seward JF. Varicella. Lancet 2006; 368:1365-1376.
Abstract
Keywords
References
- Curry MP, Chopra S. Acute Viral Hepatitis. In: Mandell GL, Bennett JE, Dolin R, (eds). Principles and Practice of Infectious Diseases. 7th ed. Philadelphia: Churchill Livingstone; 2010:1577-1592.
- Perz JF, Armstrong GL, Farrington LA, Hutin YJ, Bell BP. The contribution of hepatitis B and hepatitis C virus infection to cirrhosis and primary liver cancer worldwide. J Hepatol 2006; 45:529-538.
- Tong MJ, Hsu LY, Chang PW, Blatt LM. Evaluation of current treatment recommendations for chronic hepatitis B: a 2011 update. J Gastroenterol Hepatol 2011; 26:829-835.
- Rizzetto M, Ciancio A. Chronic HBV-related liver disease. Mol Aspects Med 2008;29:72-84.
- Jung MC, Pape GR. Immunology of hepatitis B infection. Lancet Infect Dis 2002; 2:43-50.
- Dengming He, Guohua Yan, Wang Y. Serum levels of interleukin-12 in various clinical states with hepatitis B virus infection. Cell Immunol 2012; 272:162-165.
- Megged O, Schlesinger Y. Varicella zoster infection in adults: a preventable disease. Isr Med Assoc J 2009; 11:306-307.
- Monaghan TM, Norton B. Varicella pneumonia in an immunocompromised inflammatory bowel disease patient. Inflamm Bowel Dis 2010;16:364-365.
- Sato A, Amada N, Kikuchi H, Fukumori T, Haga I, Takahashi Y. Pneumonia due to varicella-zoster virus reinfection in a renal transplant recipient. Transplant Proc 2009;41:3959-3961.
- Mohsen AH, McKendrick M. Varicella pneumonia in adults. Eur Respir J 2003;21:886-891.
- Gregorakos L, Myrianthefs P, Markou N, Chroni D, Sakagianni E. Severity of illness and outcome in adult patients with primary varicella pneumonia. Respiration 2002;69:330-334.
- Tunbridge AJ, Breuer J, Jeffery KJ. Chickenpox in adultsclinical management. J Infect 2008;57:95-102.
- Rehermann B. Chronic infections with hepatotropic viruses: mechanisms of impairment of cellular immune responses. Semin Liver Dis 2007; 27:152-160.
- Feldman S. Varicella-zoster virus pneumonitis. Chest 1994; 106 (Suppl 1):22-27.
- McCrary ML, Severson J, Tyring SK. Varicella zoster virus. J Am Acad Dermatol 1999; 41:1-14.
- Heininger U, Seward JF. Varicella. Lancet 2006; 368:1365-1376.
Details
| Primary Language | English |
|---|---|
| Journal Section | Case Report |
| Authors | |
| Publication Date | June 1, 2012 |
| Published in Issue | Year 2012 Volume: 2 Issue: 02 |