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Severe bronchiolitis probably caused by varicella-zoster virus
Critical Care Medicine
|May 1, 1982
Summary
A previously healthy young man experienced severe pneumonia likely caused by varicella-zoster virus, without typical skin rash. His selective hypercarbia (high carbon dioxide levels) responded well to theophylline treatment.
Area of Science:
- * Infectious Diseases
- * Pulmonology
- * Virology
Background:
- * Varicella-zoster virus (VZV) typically causes chickenpox and shingles.
- * Severe VZV pneumonia is rare, especially in immunocompetent individuals.
- * Pneumonia presentation can vary, sometimes lacking characteristic dermatological signs.
Observation:
- * A 19-year-old previously healthy male presented with severe pneumonia.
- * Diagnosis confirmed by high VZV antibody titers and VZV antigen in lung biopsy.
- * Absence of skin manifestations (rash) during the illness was noted.
Findings:
- * The patient exhibited selective hypercarbia, an uncommon pathophysiological feature.
- * Hypercarbia showed a positive response to bronchodilator therapy, specifically theophylline.
- * Laboratory and histological evidence confirmed VZV as the causative agent.
Implications:
- * Highlights VZV as a potential cause of severe pneumonia in young adults.
- * Suggests bronchodilator therapy, like theophylline, may manage VZV-induced hypercarbia.
- * Underscores the importance of considering VZV in atypical pneumonia cases without skin lesions.