Varicella pneumonia in the adult

Chickenpox pneumonia can occur in as many as half of the varicella-zoster infections in adults. Although it usually exhibits a benign course, this complication can cause considerable morbidity and mortality in predisposed groups, including pregnant women and immunosuppressed patients. In these patients, the use of antiviral drugs, most notably acyclovir, has been shown to lessen the morbidity of varicella-zoster infections. Early diagnosis of lung involvement from the chest x-ray or arterial blood gas measurements, even in the absence of symptoms, is essential for optimum efficacy of drug therapy. The use of acyclovir in normal hosts continues to be debated, especially for prophylaxis, because of its potential for nephrotoxicity. Judicious use of acyclovir will reduce the overall mortality from this potentially fatal complication of varicella zoster virus infection.