Calcification in Chickenpox Pneumonia

doi:10.1378/chest.60.5.504

Chest

Volume 60, Issue 5, November 1971, Pages 504-507

https://doi.org/10.1378/chest.60.5.504 Get rights and content

Abstract

The relationship between pulmonary calcifications and chickenpox pneumonia is reviewed. A case is presented in which pulmonary calcification developed over a seven-year interval following Varicella pneumonia in a patient who had a previously negative chest radiograph. After accidental death, an autopsy was performed and the pulmonary findings are presented. It is felt that an etiologic relationship has been established between the patient's Varicella pneumonia and her subsequent pulmonary calcifications.

Section snippets

REVIEW OF LITERATURE

Much of the credit for making the profession aware of focal calcifications in the chest as a result of chickenpox pneumonia goes to authors from Australia and New Zealand. Of these Mackay and Cairney¹ are generally credited with the first description of this entity in 1960. Review of the literature, however, reveals that an earlier description of calcification following Varicella pneumonia appeared in a paper published by Buechner² in the Annals of Internal Medicine in October of 1959. During

CASE REPORT

Our patient was a 29-year-old woman physician who on March 1, 1959, became acutely ill with chills and fever. After approximately 72 hours a rash developed. She had pain in her left upper quadrant and a hacking cough as well as expiratory wheezes. The cough and rash appeared simultaneously. Her temperature was 99.8° F but within 24 hours went to 104°. The patient had generalized rales and a rash typical of chickenpox. She was severely dyspneic. The blood count was consistent with a viral

Pathologic Process

The acute process in Varicella pneumonia occurs in the alveoli where one sees swelling, proliferation and desquamation of septal cells together with infiltration by mononuclear cells. In many areas necrosis and hemorrhage occur. Bacteria are rare. Type A inclusion bodies may be present. The process is diffusely distributed and may be seen throughout the lung and on the pleural surface. Many of the lesions heal by resolution. The more severely affected areas go on to fibrosis and where there is

COMMENT

Varicella pneumonia should ultimately prove to be one of the more frequent causes of diffuse calcific foci in the lungs. In a recent publication Brunton and Moore⁷ surveyed 16,894 people and found 463 or 2.7 percent with a history of chickenpox in adult life. Among these there were eight patients who had diffuse calcification presumed to have been caused by chickenpox pneumonia. This reflected an incidence of 1.7 percent who underwent subsequent calcification. Since eight occurred among

ACKNOWLEDGMENT

I am grateful to Dr. Earl B. Wert and Dr. Thomas D. Davis for their help with the pathology in this case and to Dr. Samuel Eichold for the interesting clinical history. Mrs. Norma Breazeale is commended for her help in the preparation of this paper.

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