Varicella Pneumonia in a Healthy Adult Presenting with Severe Respiratory Failure.

Shirai, Toshihiro; Sano, Keigo; Matsuyama, Satoru; Honjo, Yumiko; Takashima, Misako; Sasada, Yuzo; Takayanagi, Shigekazu; Nagamatsu, Kiyoaki; Nawano, Mitsumasa; Fushimi, Misao; Imokawa, Shiro; Sato, Atsuhiko

doi:10.2169/internalmedicine.35.315

Cited by 17 publications

(12 citation statements)

References 4 publications

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“…[21][22][23][24] IVIG has also demonstrated efficacy in the treatment of other viral pneumonias. [25][26][27] Nevertheless, our preliminary results showed that, in SARS patients, the development of respiratory failure was not associated with less frequent or delayed use of IVIG.…”

Section: Panesarmentioning

confidence: 59%

Clinical Characteristics, Management and Prognostic Factors in Patients with Probable Severe Acute Respiratory Syndrome (SARS) in a SARS Center in Taiwan

Liu

Huang

Lai

et al. 2005

Journal of the Chinese Medical Association

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Section: Panesarmentioning

confidence: 59%

Clinical Characteristics, Management and Prognostic Factors in Patients with Probable Severe Acute Respiratory Syndrome (SARS) in a SARS Center in Taiwan

Liu

Huang

Lai

et al. 2005

Journal of the Chinese Medical Association

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“…29,[39][40][41] Two patients received intravenous immunoglobulin (IVIG) together with intravenous acyclovir had a favorable outcome. 42,43 The mortality of patients who received acyclovir or vidarabine alone was seven out of 68 (10.3%), whereas four patients managed with supportive care died. Only one out of 25 patients died if intravenous acyclovir was initiated within 4 days of admission.…”

Section: Resultsmentioning

confidence: 99%

“…27,34,35 There was no death in patients treated with a combination of acyclovir and immunomodulators such as corticosteroid and IVIG. 28,29,[39][40][41][42][43] As for adenoviral pneumonia, no antiviral was ever used for their treatment. Two of four (50%) patient receiving steroid died, which appeared to be higher than patients managed conservatively.…”

Section: Resultsmentioning

confidence: 99%

Medical treatment of viral pneumonia including SARS in immunocompetent adult

Cheng

Tang

et al. 2004

Journal of Infection

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Since no randomized controlled trials have been conducted on the treatment of viral pneumonia by antivirals or immunomodulators in immunocompetent adults, a review of such anecdotal experience are needed for the more rational use of such agents. Case reports (single or case series) with details on their treatment and outcome in the English literature can be reviewed for pneumonia caused by human or avian influenza A virus (50 patients), varicella zoster virus (120), adenovirus (29), hantavirus (100) and SARS coronavirus (SARS-CoV) (841). Even with steroid therapy alone, the mortality rate appeared to be lower when compared with conservative treatment for pneumonia caused by human influenza virus (12.5% vs. 42.1%) and hantavirus (13.3% vs. 63.4%). Combination of an effective antiviral, acyclovir, with steroid in the treatment of varicella zoster virus may be associated with a lower mortality than acyclovir alone (0% vs. 10.3%). Combination of interferon alfacon-1 plus steroid, or lopinavir/ritonavir, ribavirin plus steroid were associated with a better outcome than ribavirin plus steroid (0% vs. 2.3% vs. 7.7%, respectively). Combination of lopinavir/ritonavir plus ribavirin significantly reduced the virus load of SARS-CoV in nasopharyngeal, serum, stool and urine specimens taken between day 10 and 15 after symptom onset when compared with the historical control group treated with ribavirin. It appears that the combination of an effective antiviral and steroid was associated with a better outcome. Randomized therapeutic trial should be conducted to ascertain the relative usefulness of antiviral alone or in combination with steroid.

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“…Varicella-induced ARDS in adults is very rare but potentially life-threatening (24,(26)(27)(28)(29)(30)(31)(32)(33)(34). We treated the present patient with steroidpulse therapy in combination with hemofiltration, a mechanical respiratory support and acyclovir administration.…”

Section: Discussionmentioning

confidence: 99%

Fulminant Varicella Infection Complicated with Acute Respiratory Distress Syndrome, and Disseminated Intravascular Coagulation in an Immunocompetent Young Adult

et al. 2004

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Primary varicella infection in immunocompetent adults is very rare, but it has a high mortality rate because of serious complications. We describe a case of varicella infection in a previously healthy young adult complicated with acute respiratory distress syndrome (ARDS), rhabdomyolysis, acute hepatitis and disseminated intravascular coagulation (DIC). Acyclovir was administered for varicella infection and the ARDS was successfully treated with steroidpulse therapy, hemofiltration and a mechanical respiratory support with a positive end-expiratory pressure. Early administration of antiviral agents and extensive management were thought to be necessary for such patients with severe complications.

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Varicella Pneumonia in a Healthy Adult Presenting with Severe Respiratory Failure.

Cited by 17 publications

References 4 publications

Clinical Characteristics, Management and Prognostic Factors in Patients with Probable Severe Acute Respiratory Syndrome (SARS) in a SARS Center in Taiwan

Clinical Characteristics, Management and Prognostic Factors in Patients with Probable Severe Acute Respiratory Syndrome (SARS) in a SARS Center in Taiwan

Medical treatment of viral pneumonia including SARS in immunocompetent adult

Fulminant Varicella Infection Complicated with Acute Respiratory Distress Syndrome, and Disseminated Intravascular Coagulation in an Immunocompetent Young Adult

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