From the Guidelines
Pulmonary Manifestations of Herpes Zoster Infection
Herpes Zoster (Varicella-Zoster Virus) infection can lead to pulmonary complications, particularly in immunocompromised individuals.
- The most common pulmonary manifestation is pneumonia, which can be severe and life-threatening in immunocompromised patients 1.
- Other pulmonary complications include visceral involvement, which can occur in disseminated cases of Herpes Zoster 1.
- Dissemination of the virus can lead to generalized skin eruptions, central nervous system, pulmonary, hepatic, and pancreatic complications, typically in immunocompromised persons 1.
- HIV-infected patients are susceptible to a variety of pulmonary complications, including those caused by Herpes Zoster, especially when the CD4+ count is <200 cells/µL 1.
- The treatment of choice for VZV infections in compromised hosts is high-dose intravenous acyclovir, while oral acyclovir, famciclovir, and valacyclovir are beneficial for mild cases in otherwise healthy hosts or as completion therapy after initial intravenous treatment 1.
From the Research
Pulmonary Manifestations of Herpes Zoster (Varicella-Zoster Virus) Infection
- Varicella-zoster virus (VZV) infection can cause viral pneumonia, which is a rare but important complication, especially in immunocompromised patients 2.
- Approximately 5%-15% of adult varicella can produce pulmonary manifestations, including varicella pneumonitis, which can occur in at-risk individuals such as pregnant women, smokers, and those with chronic lung diseases or immunosuppression 3, 4.
- Pulmonary symptoms of varicella pneumonia typically include cough, fever, and dyspnea, and can occur 1 to 6 days after VZV infection 4.
- Risk factors for progression to pneumonia include pregnancy, age, smoking, chronic obstructive pulmonary disease, and immunosuppression 3, 4.
- Computed tomography (CT) manifestations of varicella zoster virus (VZV) pneumonia can include diffuse bilateral lung involvement, and can be seen in immunocompromised hosts, such as those after solid organ transplantation 5.
- Treatment of varicella pneumonia typically involves a 7-day course of intravenous acyclovir, and early intervention may modify the course of this complication 4.