Objective. To study the clinical, therapeutic, and evolutive features
in 25 patients with the diagnosis of varicella pneumonia (VP) in the l
ast 15 years. Patients and methods: The diagnosis was established by c
linical and radiologic criteria in the course of varicella infection.
The antecedents of smoking habit, pregnancy, and underlying disease we
re evaluated. Hypoxemia was defined as a pO(2) less than or equal to 6
5 mmHg with a FiO(2) of 0.21. Results. Twenty-five patients (16 males
and 9 women; mean age 31.5 years, range: 24-43 years) were included in
the study. Ninety-two percent of patients were smokers of more than 2
0 cigarettes a day; five met criteria of simple chronic bronchitis, 3
were known carriers of human immunodeficiency virus (HIV) and one had
a chronic liver disease caused by hepatitis C virus. In 16 patients (6
4%) there were no underlying diseases and none of the female patients
was pregnant. Respiratory symptoms began from the first and seventh da
y after the skin rash, and the most common symptoms were cough (76%),
dyspnea (48%), and chest pain (44%). In 22 patients an arterial gas de
termination was obtained and hypoxemia was documented in 8 patients (3
2%). Hypoxemia was greater and statistically significant in patients w
ith underlying diseases (p < 0.01). Chest X-ray revealed an interstiti
al pattern predominantly at both bases. Intravenous acyclovir therapy
was started in 19 patients (76%) with severe respiratory symptoms and/
or underlying disease. Three patients (12%) were admitted to the Inten
sive Care Unit for mechanical ventilation. All patients had a favourab
le clinical course. Conclusions. Adult patients with symptoms of VP ha
d a favourable clinical course with intravenous acyclovir, and the pre
sence of hypoxemia was more commonly observed when underlying diseases
were also present.