PURPOSE: The objective of this study was to analyze the epidemiological, clinical, radiographic and prognostic characteristics in a large simple of patients with VZV pneumonia in a Spanish region (Valencia, Spain).
METHODS: A 10-year retrospective, descriptive, observational study was carry out in several hospitals. We studied 46 patients with VZV pneumonia, 21 men and 25 women, with a mean age 36±11 years, and 35 were smokers (76%).
RESULTS: The symptoms were: fever (83%), cough (83%), dyspnea (63%), pleuritic pain (70%), and hemoptysis (6%). Onset of blisters preceded chest problems in 3-5 days, but in 5 patients (11%) respiratory symptoms appeared first. A contact with an index case was observed in 57% of patients. Arterial blood gases showed a mean PO2/FiO2 of 308±101 and 30 patients had a PO2 lower than 55 mmHg. In this group of patients with acute respiratory failure, 11 were admitted to the ICU and 8 required mechanical ventilation. Comparison of patients in ICU with those on general wards showed differences in the duration of fever (6.1±4.2 vs 3.2±1.1 days, p< 0.001), mean stay (16.8±9.3 vs 7.2±2.4 days, p< 0.001), and presence of acute renal failure (p=0.01) and acute respiratory failure (p< 0.001). There were no deaths in the whole group. Treatments included acyclovir (98%) combined with steroids in 6 patients and with antibiotics in 3 (complicated with bacterial pneumonia). The prevalence was 0.33/100,000 inhabitants/year.
CONCLUSION: We conclude that VZV pneumonia may have a severe course, with 23% of ICU admissions. Smoking was a risk factor for VZV pneumonia.
CLINICAL IMPLICATIONS: Absence of mortality may be related to early treatment with acyclovir.
DISCLOSURE: Jaime Signes-Costa, No Financial Disclosure Information; No Product/Research Disclosure Information