A 52-year-old male agricultural worker without prior varicella immunity presented with fever, cough, and a rapid onset of a pruritic vesicular rash, eventually diagnosed with varicella pneumonia. Clinical evaluation showed hypoxia and pulmonary infiltrates indicated by imaging, confirmed by PCR testing of vesicular fluid. Treatment with intravenous acyclovir led to rapid recovery. Varicella pneumonia, characterized by vesicular rash and respiratory symptoms, poses significant risks in adults without immunity, necessitating early antiviral therapy.

Source: JAMA Clinical Challenge