Complications of chickenpox: hepatitis and extensive pneumonia in an adult patient with tuberculosis. A challenging diagnosis

Authors

  • Luzia Salomé Afonso-Amaro-Bismarck Unidad de Salud Local del Oeste, Servicio de Medicina Interna, Hospital de Torres Vedras, Portugal https://orcid.org/0009-0006-8919-923X
  • Marina Coelho Unidad de Salud Local del Oeste, Servicio de Medicina Interna, Hospital de Torres Vedras, Portugal https://orcid.org/0009-0009-8667-7808
  • Manuel Ribeiro Unidad de Salud Local del Oeste, Servicio de Medicina Interna, Hospital de Torres Vedras, Portugal https://orcid.org/0000-0002-9461-274X
  • Henrique Alves-de Sousa Unidad de Salud Local del Oeste, Servicio de Medicina Interna, Hospital de Torres Vedras, Portugal
  • Cláudia Fernandes Unidad de Salud Local del Oeste, Servicio de Infectología, Hospital de Torres Vedras, Portugal

DOI:

https://doi.org/10.32818/reccmi.a10n1a5

Keywords:

primary infection, varicella, pneumonia, immunocompetent adult, hepatitis, tuberculosis

Abstract

In immunocompetent adults, varicella pneumonia is relatively rare but is a common complication of primary infection with the varicella-zoster virus (VZV), with a reported mortality rate ranging from 10% to 30%, according to the literature. Initial symptoms typically appear between 1 and 6 days after the rash’s onset. Despite the low incidence of
complications, a high index of suspicion is necessary to enable early treatment. We present the case of a 32-year-old man with a history of tuberculosis, admitted with primary varicella infection, pneumonia and hepatitis. We present the case of a 32-year-old man with a history of tuberculosis, admitted with primary varicella infection, de novo pneumonia, and hepatitis.

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References

Arias-Osorio C, Lozada-Ramos H, Daza-Arana J, Osorio-Toro L, Bonilla-Bonilla D. Varicella pneumonia in an immunocompetent adult patient: Case report and review of the literature. Respiratory Medicine Case Reports. 2024; 52.

doi: https://doi.org/10.1016/j.rmcr.2024.102112 (último acceso mar. 2025). DOI: https://doi.org/10.1016/j.rmcr.2024.102112

Mohsen AH, Peck RJ, Mason Z, Mattock L, McKendrick MW. Lung function tests and risk factors for pneumonia in adults with chickenpox. Thorax. 2001; 56(10): 796-99. doi: https://doi.org/10.1136/thorax.56.10.796 (último DOI: https://doi.org/10.1136/thorax.56.10.796

acceso mar. 2025).

Cheng R, Lin F, Deng Z, Liang J, Li X, et al. Prevalence and progression of pneumonia in immunocompetent adults with varicella. Virol J. 2024; 21: 39. doi: https://doi.org/10.1186/s12985-024-02303-3 (último acceso mar. 2025). DOI: https://doi.org/10.1186/s12985-024-02303-3

Venkatesh SK, Li-Lin Lo L. CT appearance of varicella zoster lesions in liver and spleen in an immunocompetent patient. Journal of Clinical Virology. 2006. 36(4): 303-05. doi: https://doi.org/10.1016/j.jcv.2006.04.006 (último DOI: https://doi.org/10.1016/j.jcv.2006.04.006

acceso mar. 2025).

Shirai T, Sano K, Matsuyama S, Honjo Y, Takashima M, et al. Varicella pneumonia in a healthy adult presenting with severe respiratory failure. Intern Med. 1996; 35(4): 315-18. doi: https://doi.org/10.2169/internalmedicine.35.315 DOI: https://doi.org/10.2169/internalmedicine.35.315

(último acceso mar. 2025).

Qasem S, Almutairi R, Elhousiny M, Albazzali A. Varicella pneumonia in immunocompetent adults: symptomatic and asymptomatic cases. Cureus. 2024; 16(9): e68891. doi: https://doi.org/10.7759/cureus.68891 (último acceso mar. 2025). DOI: https://doi.org/10.7759/cureus.68891

Wang CA, Chen CH, Hsieh WC, Hsu TJ, Hsu CY, et al. Risk of herpes zoster in patients with pulmonary tuberculosis. A population-based cohort study. Int J Environ Res Public Health. 2023; 20(3): 2656. doi: https://doi.org/10.3390/ DOI: https://doi.org/10.3390/ijerph20032656

ijerph20032656 (último acceso mar. 2025).

Mohsen AH, McKendrick M. Varicella pneumonia in adults. Eur Respir J. 2003; 21(5): 886-91. doi: https://doi.org/10.1183/09031936.03.00103202 (último acceso mar. 2025). DOI: https://doi.org/10.1183/09031936.03.00103202

Denny JT, Rocke ZM, McRae VA, Denny JE, Fratzola CH, et al. Varicella pneumonia: case report and review of a potentially lethal complication of a common disease. J Investig Med High Impact Case Rep. 2018; 6: 26-28. doi:

https://doi.org/10.1177/2324709618770230 (último acceso mar. 2025). DOI: https://doi.org/10.1177/2324709618770230

Published

2025-04-28

How to Cite

1.
Afonso-Amaro-Bismarck LS, Coelho M, Ribeiro M, Alves-de Sousa H, Fernandes C. Complications of chickenpox: hepatitis and extensive pneumonia in an adult patient with tuberculosis. A challenging diagnosis. Rev Esp Casos Clin Med Intern [Internet]. 2025 Apr. 28 [cited 2025 Apr. 30];10(1):14-7. Available from: https://www.reccmi.com/RECCMI/article/view/1109