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Time course of skin rash, computed tomography findings, and viral load in a rheumatoid arthritis patient with severe varicella pneumonia.
Kobayashi, Hironori; Takeuchi, Shunta; Torii, Yuka; Ikenouchi, Tadasuke; Kawada, Jun-Ichi; Oka, Keisuke; Kato, Sayaka; Ogawa, Masahiro.
Afiliación
  • Kobayashi H; Department of Respiratory Medicine, Handa City Hospital, 2-29 Touyou-cho, Handa-shi, Aichi 475-8599, Japan.
  • Takeuchi S; Department of Respiratory Medicine, Handa City Hospital, 2-29 Touyou-cho, Handa-shi, Aichi 475-8599, Japan.
  • Torii Y; Department of Pediatrics, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550, Japan.
  • Ikenouchi T; Department of Respiratory Medicine, Handa City Hospital, 2-29 Touyou-cho, Handa-shi, Aichi 475-8599, Japan.
  • Kawada JI; Department of Pediatrics, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550, Japan.
  • Oka K; Department of Infectious Diseases, Nagoya University Hospital, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550, Japan.
  • Kato S; Department of Respiratory Medicine, Handa City Hospital, 2-29 Touyou-cho, Handa-shi, Aichi 475-8599, Japan.
  • Ogawa M; Department of Respiratory Medicine, Handa City Hospital, 2-29 Touyou-cho, Handa-shi, Aichi 475-8599, Japan.
IDCases ; 33: e01866, 2023.
Article en En | MEDLINE | ID: mdl-37559973
Varicella-zoster virus (VZV) infection in adults or immunocompromised patients has a more severe presentation compared to the mild disease in children. To the best of our knowledge, no reports have described the clinical course of VZV pneumonia focusing on time course of skin rash, chest computed tomography (CT) findings, and viral load. Furthermore, no reports have described the reactivation of human herpes virus 6 (HHV-6) in VZV pneumonia. Here, we report a case of severe VZV pneumonia that resulted in reactivation of HHV-6 in a patient with rheumatoid arthritis (RA). A 66-year-old female treated for RA was admitted to our hospital with papules. Her chest CT showed granular infiltrates, micronodules, and ground-glass opacities. The day after admission, because the typical skin rashes and chest CT findings were observed, she was diagnosed with VZV pneumonia and treated with acyclovir. Her skin rash then crusted over five days and entered the healing process, whereas it took approximately two weeks for her respiratory condition and chest CT findings to improve. In addition, VZV deoxyribonucleic acid (DNA) gradually decreased with treatment. On the 34th day of admission, VZV DNA was not found in the serum sample but remained in the sputum sample. Furthermore, although reactivation of HHV-6 was observed, viremia resolved without treatment. Clinicians should be able to recognize the differences in the improvement of skin rashes, respiratory status, and chest CT findings. In addition, treatment for HHV-6 reactivation should be carefully determined for each case.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Diagnostic_studies Idioma: En Revista: IDCases Año: 2023 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Países Bajos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Diagnostic_studies Idioma: En Revista: IDCases Año: 2023 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Países Bajos