Varicella pneumonia in southern Israel: clinical characteristics, diagnosis and therapeutic considerations.
BACKGROUND
The most common and most serious complication of varicella (chickenpox) in adults is pneumonia, which can lead to severe respiratory failure. Varicella pneumonia is associated with considerable morbidity and even death.


OBJECTIVE
To summarize our experience with varicella pneumonia in terms of clinical, laboratory and radiological characteristics as well as risk factors, management and outcome.


METHODS
We conducted a retrospective cohort survey in our facility from 1995 to 2008.


RESULTS
Our cohort comprised 21 patients with varicella pneumonia, of whom 19 (90%) were men; their mean age was 35 +/- 10.5 years. Nineteen patients (90%) were Bedouins and 18 (86%) were smokers. Eleven (52%) were admitted to the Medical Intensive Care Unit; 3 of them required mechanical ventilation and the remaining 10 (48%) were admitted to the general medical ward. Median length of stay was 6 +/- 7.7 days. Hypoxemia and elevated lactate dehydrogenase on admission were associated with respiratory failure. Radiological manifestations were variable and nine patients exhibited characteristic findings. All but one patient were treated with acyclovir. All patients fully recovered.


CONCLUSIONS
In southern Israel varicella pneumonia is primarily a disease ofyoung male Bedouins who are smokers. Severity ranges from mild disease to severe, resulting at times in respiratory failure requiring mechanical ventilation. Prognosis is favorable with complete recovery.
Avnon
Lone S
LS
Division of Pulmonary Medicine, Soroka University Medical Center and Faculty of Health Sciences, Beer Sheva, Israel.
Smolikov
Alexander
A
Almog
Yaniv
Y
D000212:Acyclovir / Q000627:therapeutic use; D000293:Adolescent; D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use; D002644:Chickenpox / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D005260:Female; D014645:Herpesvirus 3, Human / Q000472:pathogenicity; D006801:Humans; D007557:Israel / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011024:Pneumonia, Viral / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology / Q000628:therapy; D012121:Respiration, Artificial; D012189:Retrospective Studies; D012907:Smoking / Q000009:adverse effects; D055815:Young Adult
D000998:Antiviral Agents; D000212:Acyclovir