title: Recurrent varicella pneumonia complicating an endogenous reactivation of chickenpox in an HIV-infected adult patient.
abstract: We report the case of an adult patient with acquired immune deficiency syndrome (AIDS) presenting with acute dyspnoea and cutaneous disseminated lesions suggestive of an atypical varicella. The chest radiograph and the computed tomography (CT)-scan revealed a miliary pneumonia. On a previous serum sample varicella-zoster (VZV)-specific serum immunoglobulin (Ig)G titre was 1/200. A high dose acyclovir treatment was effective, but recurrences occurred twice when the treatment was discontinued. During the first recurrence the polymerase chain reaction (PCR) detected the presence of VZV in the bronchoalveolar lavage (BAL) sample. These findings confirmed the diagnosis of secondary varicella with pulmonary involvement. Secondary varicella pneumonia has not been reported in a human immunodeficiency virus (HIV)-infected adult until now. The use of PCR on a BAL sample was very useful in this case because viral culture remained negative. Recurrences of the varicella pneumonia suggested that a maintenance treatment was required in this deeply immunocompromised patient.
authors.affiliation: Service de pneumologie, Hôpital de Hautepierre, Strasbourg, France.
authors.forename: P
authors.initials: P
authors.lastname: Fraisse
authors.forename: M
authors.initials: M
authors.lastname: Faller
authors.forename: D
authors.initials: D
authors.lastname: Rey
authors.forename: N
authors.initials: N
authors.lastname: Labouret
authors.forename: M
authors.initials: M
authors.lastname: Partisani
authors.forename: F
authors.initials: F
authors.lastname: Stoll-Keller
authors.forename: J M
authors.initials: JM
authors.lastname: Lang
authors.forename: E
authors.initials: E
authors.lastname: Weitzenblum
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000150:complications* / Q000821:virology; D000212:Acyclovir / Q000627:therapeutic use; D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use; D001992:Bronchoalveolar Lavage Fluid / Q000821:virology; D002644:Chickenpox / Q000150:complications* / Q000188:drug therapy; D014645:Herpesvirus 3, Human / Q000302:isolation & purification; D006801:Humans; D008297:Male; D011024:Pneumonia, Viral / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D016133:Polymerase Chain Reaction; D012008:Recurrence
chemical_list: D000998:Antiviral Agents; D000212:Acyclovir