Varicella Pneumonia in an Adult with Immunocompromised Status: Case Report

Varicella is an acute infectious disease caused by the varicella zoster virus. It mainly occurs in infants and preschool children, the morbidity is only 2% in adults. Adult chickenpox is a self-limited disease, which is easier to control the development of rashes to some certain extent, shorten the course of the disease, reduce or avoid long-term complications. We present the case of a 23-year-old man with varicella. He had a two-day fever and four-hour erythematous rashes. The rashes spread around the face, two arms, and trunk. No special finding was in laboratory examination but low immunity. Computed tomography of the chest revealed obvious pneumonia manifestation of two lungs. Varicella pneumonia was considered and antiviral therapy, as well as Chinese patent drug of inhibiting lung-energy and dispersing heat, were applied. Fourteen days later, he was fully recovered. Varicella pneumonia was one of the severe forms, especially in hypoimmunity patients while low immunity may be its main cause. All patients with varicella should detect immunity-related laboratory tests included in lymphocyte subsets, which was important to help their recovery and cut costs.

Effects of Intravenous Immunoglobulin and Acyclovir in Preventing Neonatal Varicella

Neonatal varicella mostly results from maternal varicella. The disease can cause presentation ranging from mild symptoms to varicella pneumonia, hepatitis, meningoencephalitis, or fatality. If the mother develops symptoms implying varicella 4–5 days antepartum to 2 days postpartum, the mortality rate of the baby may reach 20%. We report a case of neonatal varicella from maternal varicella. The patient’s mother initially developed maculopapular rash over her trunk 1 day after giving birth; she had a family member in the same household diagnosed with herpes zoster recently, and another member with diagnosed varicella, whose rash disappeared before the patient's birth. On the baby's third day of life, discrete vesicular rashes on erythematous background and discrete erythematous maculopapular rashes were found over his trunk, arms, and legs. The baby was subsequently diagnosed with neonatal varicella and was treated by intravenous immunoglobulin (IVIG) because there was no varicella zoster immunoglobulin (VZIG) available in the hospital, and also, intravenous acyclovir was given for 7 days. The rash completely resolved by the baby's fifth day of life, without any complications. The combination of IVIG and acyclovir might not effectively prevent neonatal varicella, but the medication could prevent the baby from developing serious complications and shorten the clinical course.