VARICELLA PNEUMONIA IN ADULTS

Ali Hassan Abro, Ahmed MS Abdou, Jawahar L Gangwani, Abdulla M Ustadi, Hina Seyada Hussaini

Abstract


Background: Varicella pneumonia is the major and most frequent complication of chicken pox in healthy adults and carries a significant morbidity and mortality despite mechanical respiratory support and antiviral therapy. This study was undertaken to describe the frequency, severity and outcome of varicella pneumonia complicating chicken pox adult patients admitted in the hospital.
Material and Methods: This was a descriptive study of all adult patients with diagnosis of chicken pox who were admitted to the Infectious Diseases unit of Rashid hospital Dubai, UAE, from July 2005-Feb 2008. The patients were considered to have varicella pneumonia if the chest radiograph on admission showed changes consistent with acute infection (diffuse nodular/reticular changes), as reported by the radiologist. The patients with varicella pneumonia
were treated by intravenous Acyclovir and those with severe varicella pneumonia in addition to Acyclovir, also received intravenous antibiotics, corticosteroids and mechanical ventilation.
Results: A total of 97 adult patients were entered in the study. Twenty-eight (28.8%) patients developed varicell pneumonia. Smokers and age of 35 years and above had more than three-fold increase of risk of developing varicell pneumonia, (p <0.01 and p < 0.005 respectively). High frequency of varicell pneumonia was also observed in males (p <0.05) and in patients with
respiratory symptoms (p <0.0001). Patients with varicella pneumonia had increased incidence of hepatic dysfunction, renal impairment (P <0.02) and thrombocytopenia (P <0.02). Out of 28 patients with varicella pneumonia, 10 (35.7%) required mechanical ventilation. Hospital stay was longer in patients with varicella pneumonia than those without pneumonia (p <0.002). Five
patients died which accounted for 17.8% of the patients with varicella pneumonia and 50% of the patients on ventilators.
Conclusion: In conclusion, high frequency of varicella pneumonia was observed in chicken pox patients with older age group, males, smokers and patients who presented with respiratory symptoms. The patients who developed varicella pneumonia also had involvement of the other organs leading to high morbidity and mortality. Early administration of Acyclovir, corticosteroids and mechanical ventilation may be of benefit for severe varicella pneumonia in adults.


Keywords


Varicella; Pneumonia; Adults

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