Varicella-Zoster Infection in Adult Males: Risk Factors for Varicella-Zoster Virus Pneumonia

Objectives: To study the risk factors for varicella pneumonia (VP) in adults and to predict the early progression to severe pneumonitis in order to establish early therapeutic intervention Design: Prospective study Setting: Infectious Diseases Hospital Subjects and Methods: Fifty-two male patients with VP and 52 Varicella patients without pneumonia as control. Beside history taking and routine work-up, all cases were subjected to arterial blood gas analysis, and hypoxemic index (HI) was calculated as an indicator for severity of pneumonia Interventions: Arterial blood gas analysis Main Outcome Measures: Occurrence of VP Results: Univariate analysis revealed significant associations between pulmonary findings, chronic diseases, severe varicella rash and smoking in patients with VP than those without pneumonia (p = 0.001, 0.03, 0.001, 0.03 respectively). Blood gas analysis showed significantly lower mean values of PaO2, SaO(2) and hypoxemic index in patients with VP than controls (p = 0.001). However, the mean PaCO2 was significantly higher in the same patient group (p = 0.001). Multivariate analysis demonstrated that older age, clinical pulmonary findings, severe varicella rash, low PaO2, low HI and FDPs > 1000 were significantly associated with VP. Conclusion: In adult males with VP, presence of HI < 150, generalized radiological pulmonary opacities, FDPs > 1000, low PaO2 and SaO(2)% could be considered good predictors of progression to serve VP. These factors should alert the physician for an early intervention as VP is potentially life-threatening.