Lung
Infectious
Viral
Varicella zoster
Author: Elliot Weisenberg, M.D.
Last author update: 1 September 2011
Last staff update: 7 August 2020
Copyright: 2003-2024, PathologyOutlines.com, Inc.
PubMed search: varicella zoster pneumonia
Cite this page: Weisenberg E. Varicella zoster. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/lungnontumorVZV.html. Accessed December 25th, 2024.
Clinical features
- Overwhelmingly a benign disease in childhood (Eur J Clin Microbiol Infect Dis 2011;30:435)
- Adults with infection have 25× risk of children in developing pneumonia; occurs in 10% - 15% of adult patients (Ann Thorac Med 2007;2:163)
- Greatest risk of severe disease in immunosuppressed patients, especially bone marrow transplant recipients, patients with chronic lung disease, pregnant women and neonates
- Incidence has declined with effective treatment, but is increasing due to unvaccinated individuals
- Diagnosis usually apparent from skin lesions and clinical history, but immunohistochemistry, culture or PCR may be necessary to rule out HSV
- Pneumonia usually occurs 2 - 7 days after rash appears
- Pulmonary calcifications may occur after recovery
- Untreated pneumonia has 10% - 40% mortality rate
Gross description
- Heavy, firm and purple lungs
- May have hemorrhagic lesions on pleura resembling skin lesions
Microscopic (histologic) description
- Necrosis of bronchial and alveolar epithelium, acute inflammation and hemorrhage, eosinophilic nuclear inclusions and rare multinucleated cells at edge of necrotic foci
