Varicella pneumonitis is a serious entity associated with morbidity and mortality. There have been sporadic reports of corticosteroids use in life-threatening varicella pneumonitis. We reported a case series of varicella pneumonitis to examine the outcome and the effect of corticosteroids use.
A retrospective chart review was conducted on all adult patient admitted to a tertiary care hospital during 1990–2002 with varicella pneumonitis. We documented oxygenation parameters (SpO2, PaO2/FIO2) on admission and after 48 hours, whether the patients were admitted to the ICU, the use of mechanical ventilation, ICU and hospital length of stay (LOS) and the hospital outcome. We compared the patients who received corticosteroids with those who did not.
We identified 14 patients with varicella pneumonitis. 5 patients received corticosteroids, in addition to anti-viral and supportive treatment. Patients who received corticosteroids were significantly more hypoxic on admission and they were all admitted to the ICU with 4 of them intubated. Only 2 of 9 were intubated in non-steroid group. Despite the higher severity, the corticosteroids group showed a much faster improvement in oxygenation. There was a trend towards shorter duration of mechanical ventilation. The duration of ICU and hospital LOS were not significantly different. All patients survived.CONCLUSIONS: Corticosteroids in severe varicella pneumonitis accelerate the physiologic recovery and may shorten the duration of mechanical ventilation.
Corticosteroids use may be a useful adjunct to the treatment of severe varicella pneumonitis.
PaO2/FIO2Steroid Group (n=5)No Steroid (n=9)p-ValueOn admission78 ± 9193 ± 290.005After 48 hours247 ± 23224 ± 440.66The change169 ± 1763 ± 190.003Mechanical ventilation (median)680.06
N. Adhami, None.