Vidarabine in fulminating chickenpox pneumonia.

Abstract

Chickenpox (varicella), a common and usually mild infection of childhood, is frequently more serious in adults. The principal complication of adult varicella is pneumonia which may be fatal in a fifth of cases.' We describe two patients with rapidly fulminating varicella pneumonia who responded to vidarabine therapy. Case reports CASE ONE A 34-year-old teacher, previously in good health, was admitted with rapidly progressive shortness of breath complicating varicella. He first became unwell four days before admission with fever, sweats, and anorexia. The varicella eruption appeared the next day and spread rapidly to cover his body and face. Two days before admission he developed severe, dull central chest pain, a dry cough, and increasing dyspnoea. His two daughters, aged 3 and 5 years, had had varicella, six and three weeks previously. On examination he looked ill and was covered with the lesions of haemorrhagic varicella. His temperature was 39 2°C, pulse 110 beats/minute, blood pressure normal, respiratory rate 30/minute, and he was

Antiviral therapy for respiratory tract infections

“…Foscarnet is a possible alternative but few reported cases had received this agent 92–94 . Vidarabine is a third option and appeared to be effective in disseminated VZV infection including pneumonia 92,95,96 . Oral acyclovir, valacyclovir and famciclovir should be avoided for this serious infection.…”

Extracorporeal Life Support for an Adult with Varicella Pneumonia

“…While the disease runs its course in healthy children, pneumonia is a common complication in adults with a reported incidence of 16%-50% (1,2). Varicella, if complicated by pneumonia in adults, has a reported mortality rate as high as 10% to 20% (3). In pregnant women the mortality rate can be as high as 30% to 40% ( 4 ).…”