Infectious disease capsules: a pox on your house

Skinmed
Steven D Burdette, Jack M Bernstein

Abstract

A 31-year-old, previously healthy white man presented to the emergency department with complaints of malaise, fevers, shortness of breath, a non-productive cough, and a "rash." His physical exam revealed a temperature of 100.2F, a pulse of 129 bpm, respiratory rate of 14 BPM, and blood pressure of 140/74 mm Hg. He was alert, oriented, and in no distress. His oropharynx was dry, his neck was supple, and cervical lymphadenopathy was absent. He had tachycardia, bilateral wheezes, and rhonchi with prolonged expirations. There was a diffuse vesicular eruption enveloping his entire body with involvement sparing his palms and soles (Figures 1 and 2). Laboratory values showed a hemoglobin of 16.0 g/dL and a white blood cell count of 7100 cells/pL, with 39%neutrophils, 23% bands, and 35% lymphocytes. His platelet count was mildly decreased to 86,000 x 103/pL. Chest radiograph revealed bilateral diffuse interstitial infiltrates. A diagnosis of acute varicella-zoster virus pneumonia (varicella pneumonia) was made, and the patient was started on IV acyclovir (10 mg/kg every 8 hours). Upon further questioning, the patient stated that his daughter had been diagnosed with "chickenpox" 7 days ago. The patient had numerous exposures to chickenp...Continue Reading

References

Jan 1, 1996·Infection Control and Hospital Epidemiology : the Official Journal of the Society of Hospital Epidemiologists of America·J S Garner
Sep 1, 1996·Infectious Disease Clinics of North America·A A GershonS Steinberg
Jul 21, 1998·Infection Control and Hospital Epidemiology : the Official Journal of the Society of Hospital Epidemiologists of America·E A BolyardS D Deitchmann
Mar 27, 2002·Eye·R Malhotra, S Hague
Feb 19, 2004·JAMA : the Journal of the American Medical Association·Marietta VázquezEugene D Shapiro
Mar 17, 2004·Journal of Clinical Virology : the Official Publication of the Pan American Society for Clinical Virology·Stephen D ShafranDaniel Candaele

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