A chest roentgenogram revealed diffuse, poorly defined, bilateral
alveolar-interstitial opacities. High-resolution computerized
tomography (CT) showed ground glass appearance, nodules whose
diameter is 5e10 mm, two right pneumatoceles and multiple
mediastinal lymphadenopathies (Fig. 1). We diagnosed varicella
pneumonia based on the presence of a typical skin rash, pulmonary
symptoms, and contact with a child with chickenpox, confirmed by
positive serology of VZV.
The diagnosis of varicella pneumonia in an immunocompetent
patient was considered. Nasal oxygen (8 L/min), intravenous
Acyclovir (10 mg/kg every 8 h) and skin care (showers with lukewarm
water and application of antiseptic and cicatrizing creams)
were promptly initiated. The patient's condition deteriorated
necessitating intubation and the use of mechanical ventilation
(ventilation mode: controlled assisted ventilation, tidal volume