RECURRENT VARICELLA PNEUMONIA COMPLICATING AN ENDOGENOUS REACTIVATIONOF CHICKENPOX IN AN HIV-INFECTED ADULT PATIENT

We report the case of an adult patient with acquired immune deficiency syndrome (AIDS) presenting with acute dyspnoea and cutaneous dissemin ated lesions suggestive of an atypical varicella. The chest radiograph and the computed tomography (CT)-scan revealed a miliary pneumonia. O n a previous serum sample varicella-zoster (VZV)-specific serum immuno globulin (Ig)G titre was 1/200. A high dose acyclovir treatment was ef fective, but recurrences occurred twice when the treatment was discont inued. During the first recurrence the polymerase chain reaction (PCR) detected the presence of VZV in the bronchoalveolar lavage (BAL) samp le. These findings confirmed the diagnosis of secondary varicella with pulmonary involvement. Secondary varicella pneumonia has not been rep orted in a human immunodeficiency virus (HIV)-infected adult until now The use of PCR on a BAL sample was very useful in this case because v iral culture remained negative. Recurrences of the varicella pneumonia suggested that a maintenance treatment was required in this deeply im munocompromised patient.