Chickenpox infection

A 25 years old teacher develops fever and an itchy rash over her face and chest. on exam : multiple papules and vesicles in varying stages of development. 1 week later she complains of cough and is found to have an infiltrate on x-ray.the most likely etiology of the infection?

• a. Streptococcus pneumoniae
• b. Mycoplasma pneumoniae
• c. Pneumocystis carinii
• d. Varicella virus
• e. Chlamydia psitacii

 The answer is d.

Varicella pneumonia develops in about 20% of adults with chickenpox. It occurs 3 to 7 days after the onset of the rash. The hallmark of the chickenpox rash is papules, vesicles, and scabs in various stages of development. Fever, malaise, and itching are usually part of the clinical picture. The differential can include some coxsackievirus and echovirus infections, which might present with pneumonia and vesicular rash. Rickettsialpox, a rickettsial infection, has also been mistaken for chickenpox.