Varicella Presentation in Adult: A Case Report
Abstract
Varicella is a disease caused by the varicella-zoster virus (VZV), a herpesvirus specific to humans. It is highly contagious but preventable through vaccination. It is usually diagnosed clinically and is often self-limiting. However, complications can include pneumonia, neurological, hematologic, ocular, renal, hepatic conditions, as well as sepsis, and secondary infections that can be fatal. Effective antiviral therapy has reduced associated morbidity and mortality. To report a case of varicella with bronchopneumonia in an adult patient. A 58-year-old male presented with persistent vesicular eruptions on the face, chest, back, and extremities. He was admitted to the emergency room and referred to dermatology. He had no history of prior varicella or vaccination. He was diagnosed with varicella with pneumonia and treated with acyclovir, cetirizine, paracetamol, and fusidic acid cream. Data were obtained through anamnesis, physical examination, and relevant supporting investigations, then qualitatively analyzed by correlating clinical findings and investigation results to confirm the diagnosis, evaluate treatment response, and construct the case narrative. Adult varicella is up to 25 times more severe than in children. The virus is transmitted via the respiratory tract with an incubation period of 10–21 days. Physical stress and disruption of circadian rhythms may impair immune response. Lesions typically start on the face and scalp and spread to the body. A This case highlights a presentation of adult varicella with systemic involvement. Early antiviral treatment can improve prognosis.
References
Abro, A. H., Ustadi, A. M., Gangwani, J. L., Abdou, A., Chandra, F. S., & Al-Haj, A. (2009). Varicella induced thrombocytopenia in adults. Pakistan Journal of Medical Sciences, 25(1), 7–11.
Andrei, G., & Snoeck, R. (2011). Emerging drugs for varicella-zoster virus infections. Expert Opinion on Emerging Drugs, 16(3), 507–535. https://doi.org/10.1517/14728214.2011.591786
Bandyopadhyay, D. (2021). Topical antibacterials in dermatology. Indian Journal of Dermatology, 66(2), 117. http://www.e-ijd.org/text.asp?2021/66/2/117/313776
Baxter, M., & Ray, D. W. (2020). Circadian rhythms in innate immunity and stress responses. Immunology, 161(4), 261–267. https://doi.org/10.1111/imm.13166
Bollaerts, K., Riera-Montes, M., Heininger, U., Hens, N., Souverain, A., Verstraeten, T., et al. (2017). A systematic review of varicella seroprevalence in European countries before universal childhood immunization: Deriving incidence from seroprevalence data. Epidemiology and Infection, 145(13), 2666–2677. https://doi.org/10.1017/S0950268817001546
Bond, D., & Mooney, J. (2010). A literature review regarding managing varicella-zoster virus: Literature review of VZV. Musculoskeletal Care, 8(2), 118–122. https://doi.org/10.1002/msc.175
Gershon, A. A., & Gershon, M. D. (2013). Pathogenesis and current approaches to control of varicella-zoster virus infections. Clinical Microbiology Reviews, 26(4), 728–743. https://doi.org/10.1128/CMR.00052-13
Leung, J., Broder, K. R., & Marin, M. (2017). Severe varicella in persons vaccinated with varicella vaccine (breakthrough varicella): A systematic literature review. Expert Review of Vaccines, 16(4), 391–400. https://doi.org/10.1080/14760584.2017.1294069
Levin, M. J., Schmader, K. E., & Oxman, M. N. (2019). Varicella and herpes zoster. In S. Kang, M. Amagai, A. L. Bruckner, A. H. Enk, D. J. Margolis, A. J. McMichael, & J. S. Orringer (Eds.), Fitzpatrick’s dermatology in general medicine (9th ed., pp. 3035–3064). McGraw Hill.
Miller, L. S. (2019). Superficial cutaneous infection and pyodermas. In S. Kang, M. Amagai, A. L. Bruckner, A. H. Enk, D. J. Margolis, A. J. McMichael, & J. S. Orringer (Eds.), Fitzpatrick’s dermatology in general medicine (9th ed., pp. 2719–2745). McGraw Hill.
Navaratnam, A. M. D., Ma, N., Farrukh, M., & Abdulla, A. (2017, December 22). Chickenpox: An ageless disease. BMJ Case Reports. https://doi.org/10.1136/bcr-2017-222027
Okumura, N., Ishikane, M., Fukushi, S., Yamada, S., Ochi, W., Iwamoto, N., et al. (2022). Varicella pneumonia in an immunocompetent, unvaccinated man: A case report. IJID Regions, 2, 60–62. https://doi.org/10.1016/j.ijregi.2021.11.006
Pedersen, B. K., & Hoffman-Goetz, L. (2000). Exercise and the immune system: Regulation, integration, and adaptation. Physiological Reviews, 80(3), 1055–1081. https://doi.org/10.1152/physrev.2000.80.3.1055
Putra, A. P. (2013). Varicella pada wanita dewasa usia 28 tahun. Fakultas Kedokteran Universitas Lampung, 1(3), 110–116.
Shibusawa, M., Motomura, S., Hidai, H., Tsutsumi, H., & Fujita, A. (2014). Varicella infection complicated by marked thrombocytopenia. Japanese Journal of Infectious Diseases, 67(4), 292–294. https://doi.org/10.7883/yoken.67.292
Siedler, A., Dettmann, M., Tolksdorf, K., Polte, C., Walter, C., & Ehlers, B. (2015). Laboratory investigations of vaccinated patients with varicella. Vaccine, 33(16), 1968–1973. https://doi.org/10.1016/j.vaccine.2015.02.074
Sterling, J. C. (2016). Viral infections. In C. E. M. Griffiths, J. Barker, T. Bleiker, R. Chalmers, & D. Creamer (Eds.), Rook’s textbook of dermatology (pp. 25.1–25.?). Wiley-Blackwell.
Tebruegge, M., Kuruvilla, M., & Margarson, I. (2006). Does using calamine or antihistamine provide symptomatic relief from pruritus in children with varicella zoster infection? Archives of Disease in Childhood, 91(12), 1035–1036. https://doi.org/10.1136/adc.2006.105114
ul Bari, A., & ber Rahman, S. (2004). Hematological abnormalities in adult patients of chicken pox. Journal of Pakistan Association of Dermatologists, 14, 193–197.
Zerboni, L., Sen, N., Oliver, S. L., & Arvin, A. M. (2014). Molecular mechanisms of varicella zoster virus pathogenesis. Nature Reviews Microbiology, 12(3), 197–210. https://doi.org/10.1038/nrmicro3215
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