Retrospective study of 106 cases of varicella in immunocompetent adults. Parameters associated with varicella pneumonia

摘要

INTRODUCTION: Varicella occurring in healthy adults may extend to the lungs. Diagnosing this complication is sometimes difficult because of the discrepancy between imaging and clinical presentation usually reported in this affection. METHOD: The authors report the result of a retrospective study on 106 immunocompetent patients including 48 cases of varicella pneumonia. This condition is defined as the presence of clinical signs of pneumonia and radiological and biological abnormalities consistent with viral pneumonitis. RESULTS: Comparison of the patients with or without varicella pneumonia (VP) showed that smoking was a risk factor for VP. Other parameters seem to be more associated with VP, such as fever greater than 38.3 degrees C, enanthem in the mouth, and biological hepatitis. In this study, 29.2% of the patients had received nonjustified acyclovir treatment because of missing specific criteria for the diagnosis of VP. CONCLUSION: An exact definition of VP and using parameters associated to VP would help to specify indication for hospitalization and acyclovir treatment. Careful monitoring of healthy patients with varicella is essential for an early detection of clinical signs requiring hospitalization.