The Rise of Varicella Pneumonia

ABSTRACT & COMMENTARY

Synopsis: Even in the absence of antiviral therapy, mortality attributed to varicella pneumonia in adults is uncommon.

Source: Nillson A, Ortqvist A. Scand J Infect Dis 1996; 28:1221-1223.

Nillson and ortqvist reviewed the cases of all 36 adults in Stockholm County, Sweden, hospitalized because of varicella pneumonia between 1980 and 1989, as well as an additional 23 patients with encephalitis. The mean age of the patients with pneumonia was 31 years; three-fourths were male. Fewer than one-third received acyclovir or corticosteroids. Thirteen (38%) of 34 had a respiratory rate of 30 per minute or greater; seven of these required supplementary oxygen, and two required assisted ventilation. There were no deaths among those with varicella pneumonia, but two of the patients with encephalitis died.

COMMENT BY CAROL A. KEMPER, MD

Current evidence indicates that the age of acquisition of varicella is rising in the United States and the United Kingdom, so that adults are increasingly affected (Fairley CK, Miller D. J Infect Dis 1996;174 (Suppl 3):S314-S319). Older studies indicate that pneumonia is the most common complication of varicella in adults, occurring in approximately one-fifth, and is associated with significant mortality. The study reviewed here suggests that, even in the absence, in most cases, of antiviral therapy, mortality attributed to varicella pneumonia in adults is uncommon. (Dr. Kemper is Associate Director, AIDS Program, Division of Infectious Diseases, Santa Clara Valley Medical Center.)