Document Detail

Varicella-zoster virus pneumonia in an adult population: has mortality decreased?
MedLine Citation:
PMID:  20055724     Owner:  NLM     Status:  MEDLINE    
Varicella-zoster virus (VZV) pneumonia is one of the most serious complications of this infection in adults. The objective of this study was to analyze the epidemiological and clinical characteristics in a large sample of patients with VZV pneumonia. This was a 10-y retrospective, descriptive, observational study. We studied 46 patients with VZV pneumonia, 21 men and 25 women, with a mean age 36 +/-11 y. A contact with an index case was observed in 57%, 76 were active smokers, 6.5% consumed drugs and 2 women were pregnant. The symptoms were: fever (83%), cough (83%), dyspnoea (63%), pleuritic pain (70%), and haemoptysis (6%) and started 3-5 days after the onset of blisters, except in 11% in whom respiratory symptoms appeared first. Arterial blood gases showed a mean PO(2)/FiO(2) of 308 +/-101 and 30 patients had a PO(2) of <55 mmHg--11 of these (4%) were admitted to the ICU, 8 required mechanical ventilation. Comparison of patients in the ICU with those on the general ward showed differences in the duration of fever (6.1 +/- 4.2 vs 3.2 +/- 1.1 days, p <0.001), mean stay (16.8+/-9.3 vs 7.2+/-2.4 days, p <0.001) and complications such as acute renal failure (p = 0.01) and acute respiratory failure (p < 0.001). Despite the severity of disease, no patient died. Once diagnosed, 98% were treated with acyclovir, combined with steroids in 6 and with antibiotics in 3 complicated with bacterial pneumonia. The prevalence for the period was 0.33 cases/100,000 inhabitants/y. In conclusion, VZV pneumonia has a severe course and accounts for a high percentage of admissions to the intensive care unit. The absence of mortality may be related to early treatment with acyclovir. Smoking was a risk factor for VZV pneumonia.
Eusebi Chiner; Irene Ballester; Isabel Betlloch; Jos? Blanquer; M Carmen Aguar; Rafael Blanquer; Estrella Fern?ndez-Fabrellas; Ada Luz Andreu; Marisa Briones; Francisco Sanz
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Scandinavian journal of infectious diseases     Volume:  42     ISSN:  1651-1980     ISO Abbreviation:  Scand. J. Infect. Dis.     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-02-08     Completed Date:  2010-04-14     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0215333     Medline TA:  Scand J Infect Dis     Country:  England    
Other Details:
Languages:  eng     Pagination:  215-21     Citation Subset:  IM    
Pneumology Section, Hospital Universitario San Juan de Alicante, Spain.
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MeSH Terms
Acyclovir / therapeutic use
Aged, 80 and over
Anti-Bacterial Agents / therapeutic use
Anti-Inflammatory Agents / therapeutic use
Antiviral Agents / therapeutic use
Herpes Zoster / complications*
Herpesvirus 3, Human / isolation & purification*
Middle Aged
Pneumonia, Viral / epidemiology*,  mortality*,  pathology,  virology
Retrospective Studies
Steroids / therapeutic use
Treatment Outcome
Young Adult
Reg. No./Substance:
0/Anti-Bacterial Agents; 0/Anti-Inflammatory Agents; 0/Antiviral Agents; 0/Steroids; 59277-89-3/Acyclovir

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