Okumura Nobumasa, Ishikane Masahiro, Fukushi Shuetsu, Yamada Souichi, Ochi Wataru, Iwamoto Noriko, Yamamoto Kei, Ujiie Mugen, Ohmagari Norio
National Center for Global Health and Medicine, Tokyo, Japan.
National Institute of Infectious Diseases, Tokyo, Japan.
IJID Reg. 2021 Dec 6;2:60-62. doi: 10.1016/j.ijregi.2021.11.013. eCollection 2022 Mar.
Varicella is a common vaccine-preventable disease that typically affects children aged 2-8 years and usually has a benign outcome. However, varicella infection in adults may cause serious complications, including varicella pneumonia. We report a case of varicella pneumonia in an immunocompetent, unvaccinated man in Japan. A 50-year-old Egyptian man who had been living in Japan for 20 years was brought to the hospital with a 3-day history of fever and a 2-day history of rash and dyspnea. Chest computed tomography revealed an 8-mm-long nodule with a halo in the right S3 segment and mild ground-glass opacities in both lungs. A final diagnosis was made based on identification of varicella-zoster virus via positive immunochromatographic test and polymerase chain reaction from a blister fluid. The patient's pneumonia had improved with acyclovir for 10 days. In Japan routine varicella vaccination in childhood (at ages 12 and 18 months) was introduced in 2014. However, in Egypt, where the patient spent his childhood, varicella vaccine is still not designated as a routine vaccination. The introduction of universal varicella vaccination in more countries and an increase in vaccination coverage are essential to reduce the number of cases of varicella infection, including varicella pneumonia.
水痘是一种常见的可通过疫苗预防的疾病，通常影响2至8岁的儿童，且一般预后良好。然而，成人感染水痘可能会引发严重并发症，包括水痘肺炎。我们报告了一例日本一名免疫功能正常、未接种疫苗的男性患水痘肺炎的病例。一名50岁的埃及男子在日本生活了20年，因发热3天、皮疹和呼吸困难2天被送往医院。胸部计算机断层扫描显示右肺上叶前段有一个8毫米长的有晕征的结节，双肺有轻度磨玻璃样混浊。通过免疫层析试验呈阳性以及从水疱液中进行聚合酶链反应检测出水痘带状疱疹病毒，从而做出了最终诊断。患者接受阿昔洛韦治疗10天后，肺炎病情有所改善。在日本，2014年开始实施儿童期（12个月和18个月龄）常规水痘疫苗接种。然而，在患者度过童年的埃及，水痘疫苗仍未被指定为常规疫苗。在更多国家引入普遍的水痘疫苗接种并提高疫苗接种覆盖率对于减少包括水痘肺炎在内的水痘感染病例数量至关重要。
