Varicella-zoster virus reactivation with severe pneumonia following convalescence from coronavirus disease: A case report and literature review

Reo Tome; Seishiro Arima; Morikazu Akamine; Hiroe Hashioka; Wakako Arakaki; Wakaki Kami; Daijiro Nabeya; Shuhei Ideguchi; Hideta Nakamura; Takeshi Kinjo; Masashi Nakamatsu; Makoto Furugen; Kazuya Miyagi; Syusaku Haranaga; Kazuko Yamamoto

doi:10.2169/internalmedicine.4932-24

Reo Tome, Seishiro Arima, Morikazu Akamine, Hiroe Hashioka, Wakako Arakaki, Wakaki Kami, Daijiro Nabeya, Shuhei Ideguchi, Hideta Nakamura, Takeshi Kinjo, Masashi Nakamatsu, Makoto Furugen, Kazuya Miyagi, Syusaku Haranaga, Kazuko Yamamoto

Author information

Reo Tome
Department of Respiratory Medicine, Okinawa Red Cross Hospital, Japan
First Department of Internal Medicine, Division of Infectious, Respiratory, and Digestive Medicine, University of the Ryukyus Graduate School of Medicine, Japan
Seishiro Arima
Department of Respiratory Medicine, Okinawa Red Cross Hospital, Japan
Morikazu Akamine
Department of Respiratory Medicine, Okinawa Red Cross Hospital, Japan
Hiroe Hashioka
First Department of Internal Medicine, Division of Infectious, Respiratory, and Digestive Medicine, University of the Ryukyus Graduate School of Medicine, Japan
Wakako Arakaki
First Department of Internal Medicine, Division of Infectious, Respiratory, and Digestive Medicine, University of the Ryukyus Graduate School of Medicine, Japan
Wakaki Kami
First Department of Internal Medicine, Division of Infectious, Respiratory, and Digestive Medicine, University of the Ryukyus Graduate School of Medicine, Japan
Daijiro Nabeya
First Department of Internal Medicine, Division of Infectious, Respiratory, and Digestive Medicine, University of the Ryukyus Graduate School of Medicine, Japan
Shuhei Ideguchi
First Department of Internal Medicine, Division of Infectious, Respiratory, and Digestive Medicine, University of the Ryukyus Graduate School of Medicine, Japan
Hideta Nakamura
First Department of Internal Medicine, Division of Infectious, Respiratory, and Digestive Medicine, University of the Ryukyus Graduate School of Medicine, Japan
Takeshi Kinjo
First Department of Internal Medicine, Division of Infectious, Respiratory, and Digestive Medicine, University of the Ryukyus Graduate School of Medicine, Japan
Masashi Nakamatsu
First Department of Internal Medicine, Division of Infectious, Respiratory, and Digestive Medicine, University of the Ryukyus Graduate School of Medicine, Japan
Makoto Furugen
First Department of Internal Medicine, Division of Infectious, Respiratory, and Digestive Medicine, University of the Ryukyus Graduate School of Medicine, Japan
Kazuya Miyagi
First Department of Internal Medicine, Division of Infectious, Respiratory, and Digestive Medicine, University of the Ryukyus Graduate School of Medicine, Japan
Syusaku Haranaga
First Department of Internal Medicine, Division of Infectious, Respiratory, and Digestive Medicine, University of the Ryukyus Graduate School of Medicine, Japan
Kazuko Yamamoto
First Department of Internal Medicine, Division of Infectious, Respiratory, and Digestive Medicine, University of the Ryukyus Graduate School of Medicine, Japan

Keywords: SARS-CoV-2, COVID-19, varicella zoster virus, viral pneumonia

JOURNAL OPEN ACCESS Advance online publication

Article ID: 4932-24

DOI https://doi.org/10.2169/internalmedicine.4932-24

Details

Abstract

An association between coronavirus disease 2019 (COVID-19) and concomitant varicella-zoster virus (VZV) reactivation has been proposed. We herein report a case of severe VZV pneumonia in a 73-year-old man who underwent corticosteroid tapering after recovering from COVID-19 and presented with fever, vesicular rashes, and hypoxemia. Chest computed tomography (CT) revealed ground-glass opacities and multiple granular shadows. Varicella-zoster virus was detected in the skin and bronchoalveolar lavage fluid. The patient was diagnosed with disseminated VZV reactivation and thereafter successfully recovered with acyclovir treatment. Physicians should consider the possibility of VZV reactivation when ground-glass opacities or patchy nodular shadows appear during the course of patients with COVID-19.

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