[Varicella pneumonia in adults infected by HIV-1. Presentation of 2 cases].

BACKGROUND: Infection by the varicella-zoster virus (VZV) is frequent in patients infected by the HIV-1. Nonetheless, visceral involvement in addition to that of pneumonia is rare, despite the important immune dysfunction found among these patients. METHODS: Varicella pneumonia was diagnosed in 2 patients with HIV-1 infection who presented cough with high fever and a characteristic rash in addition to respiratory failure and a micronodular pattern on chest radiography. The medical literature is reviewed (MEDLINE). RESULTS: An excellent clinical response was achieved with endovenous acyclovir treatment. CONCLUSIONS: The authors underline how rare is varicella pneumonia in patients with HIV-1 infection. The appearance of a pustulous vesicular rash in the context of a febrile episode leads to suspicion of this diagnosis. The treatment of choice is endovenous acyclovir (5 mg/kg/8 h). Varicella pneumonia has also been described in children with HIV-1 infection. The possible increase in patients with varicella pneumonia with be assessed, due to the immunosuppressive state of these patients. Patients not having been in contact with the varicella-zoster virus are particularly susceptible to presenting primoinfection by this virus.