Varicella pneumonia in a woman receiving methotrexate for psoriatic arthritis.

air), and respiratory rate 25 per minute. Her vesicular rash was typified by lesions at various stages of progression and crusting. Auscultation to the lungs revealed bilateral rales. Physical examination was otherwise unremarkable. Chest radiography showed bilateral consolidation with a marked interstitial component [Figure]. Laboratory tests, on presentation, showed mild thrombocytopenia (126,000 x 103/μg) and mild hyponatremia (132 mEq/L). The patient was admitted to the negative pressure suite in the internal medicine ward and was treated with intravenous acyclovir, ceftriaxone and azithromycin. Despite the treatment, her condition deteriorated; her respiratory rate rose to 40 bpm and although her oxygen saturation v aricella pneumonia accounts for the most severe complications of Varicella in adults. The mortality rate of Varicella pneumonia has been reported to be 30%, but may be significantly higher (50%) when the patient requires mechanical ventilation. Risk factors for developing Varicella pneumonia are smoking, immunosuppression, male gender, and pregnancy. The treatment of choice is intravenous acyclovir [1]. We present the case of a young woman admitted to our intensive care unit with a fulminant Varicella sepsis and pneumonia.