Article ID | Journal | Published Year | Pages | File Type |
---|---|---|---|---|
6121575 | Journal of Clinical Virology | 2013 | 5 Pages |
Abstract
Adult varicella pneumonia is a common and serious complication of varicella zoster virus (VZV) infection in pregnant woman and immunocompromised individuals, with mortality rates of 30-50%. The poor prognosis is attributable to very aggressive disease progression and delayed onset of treatment. Here, we present a case of varicella pneumonia in a 69-year-old woman following long-term immunosuppressive treatment for kidney transplant. Respiratory failure developed within 3Â d after admission for skin rash, and the patient died 28Â d later despite acyclovir and foscarnet treatment. The autopsy showed extensive mucosal airway ulcerations from the pharynx to the main bronchi and numerous VZV-infected cells. We searched PubMed, Web of Science, and EMBASE (1980 through February 2012), as well as several medical report databases created by Japanese healthcare professionals, for all reported cases of varicella pneumonia for which bronchoscopy findings were documented. Twenty-four cases were included and we found that patients with limited or shallow ulcers had favorable outcomes, whereas patients with vast and deep ulcerations had fatal outcomes. These findings indicate that bronchoscopy findings, particularly those showing bronchial involvement, may be useful for evaluating varicella pneumonia.
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Authors
Ryota Inokuchi, Kensuke Nakamura, Hajime Sato, Kazuaki Shinohara, Yuta Aoki, Kent Doi, Masataka Gunshin, Takeshi Ishii, Takehiro Matsubara, Takahiro Hiruma, Susumu Nakajima, Naoki Yahagi,