Nakamura M, Kanazawa M, Yamaguchi K, Akizuki M, Satoh S, Inada S
Department of Medicine, School of Medicine, Keio University, Tokyo, Japan.
Nihon Kyobu Shikkan Gakkai Zasshi. 1996 May;34(5):610-5.
A 56-year-old woman suffering from rheumatoid arthritis, was admitted to our hospital for evaluation of fever and dyspnea. A month before admission, she had been given a diagnosis of herpes zoster and was treated with an antiviral agent. However, a perineal eruption persisted. A chest X-ray film and a chest CT scan showed many diffuse nodular shadows in both lung fields. With conservative treatment, the shadows regressed along with the skin eruption and other symptoms. Pneumonia caused by varicella-zoster virus was diagnosed from the clinical course, chest roentgenographic and CT scan findings, and serological data. The risk of mortality in varicella-zoster pneumonia is high in adults, especially in immunosuppressed patients. Early diagnosis and effective treatment are, therefore, essential in the management of this disease. Though varicella-zoster pneumonia is rare, chest roentgenographic and CT scan findings are characteristic and suggestive. This case may serve as a reminder of the features of varicella-zoster pneumonia: many nodular shadows on the chest X-ray film and CT scan.
一名56岁患有类风湿关节炎的女性因发热和呼吸困难入院接受评估。入院前一个月，她被诊断为带状疱疹，并接受了抗病毒药物治疗。然而，会阴部皮疹持续存在。胸部X线片和胸部CT扫描显示双肺野有许多弥漫性结节状阴影。经过保守治疗，阴影随着皮肤皮疹和其他症状消退。根据临床病程、胸部X线和CT扫描结果以及血清学数据，诊断为水痘-带状疱疹病毒引起的肺炎。水痘-带状疱疹肺炎在成人中，尤其是免疫抑制患者中，死亡率很高。因此，早期诊断和有效治疗对于该病的管理至关重要。虽然水痘-带状疱疹肺炎罕见，但胸部X线和CT扫描结果具有特征性且有提示意义。该病例可提醒人们注意水痘-带状疱疹肺炎的特征：胸部X线片和CT扫描上有许多结节状阴影。
