title: [Varicella pneumonia in the adult: study of 22 cases].
abstract: BACKGROUND
  Retrospective study of the varicella pneumonia in adults with clinical, therapeutic and evolutive features in 22 patients in the last 5 years.
  
  
  METHODS
  The diagnosis was established by clinical and radiologic criteria in the course of varicella infection. The antecedents of pregnancy, smoking habit, previous contact with patients with varicella and underlying disease were evaluated.
  
  
  RESULTS
  Twenty-two patients (14 males and 8 women: mean age 31 years. range: 22-40) were included in the study. None of them were immunocompromised, 16 (72.7%) have had previous contact with varicella patients. 19 (86.3%) were heavy smokers and none of the female patients was pregnant. All patients had fever and exanthem, cough had 20 (90.9%) dyspnea 16 (72.7%), chest pain 9 (40.9%) and hemoptysis 5 (22.7%). Only two patients showed pO2 < 60 mmHg. Chest X-ray revealed an interstitial pattern in 14 cases (63.3%), and micronodular in 8 (36.3%). All patients received treatment with intravenous acyclovir. Three patients (13.6%) were admitted to the Intensive Care Unit due to respiratory insufficiency, needing mechanical ventilation one of them (4.5%). Another three developed failure renal reversible associated with acyclovir. All patients had a favourable clinical course.
  
  
  CONCLUSIONS
  We believe, that early, aggressive use of intravenous acyclovir in adult varicella pneumonia may be lifesaving, preventing progressive respiratory failure and reducing the high mortality rate of the disease. Therapy with corticosteroids should be considered in addition to antiviral therapy in patients with severe varicella pneumonia. While oral acyclovir chemoprophylaxis is probably beneficial in populations with chicken pox.
authors.affiliation: Unidad de Enfermedades Infecciosas, Hospital de Cruces, Bilbao.
authors.forename: L
authors.initials: L
authors.lastname: de la Peña
authors.forename: D
authors.initials: D
authors.lastname: Izaguirre
authors.forename: K
authors.initials: K
authors.lastname: Aguirrebengoa
authors.forename: C
authors.initials: C
authors.lastname: Grande
authors.forename: M
authors.initials: M
authors.lastname: Montejo
mesh_terms: D000212:Acyclovir / Q000627:therapeutic use; D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use; D002644:Chickenpox / Q000150:complications* / Q000188:drug therapy; D005260:Female; D006801:Humans; D008297:Male; D011024:Pneumonia, Viral / Q000188:drug therapy / Q000209:etiology*; D012189:Retrospective Studies
chemical_list: D000998:Antiviral Agents; D000212:Acyclovir
vernacular_title: Neumonía por varicela en el adulto: estudio de 22 casos.