Varicella pneumonitis in a heart transplanted patient

A 50 years old male was admitted to our hospital because of acute respiratory insufficiency requiring mechanical ventilation. Four months earlier he had undergone heart transplantation. Three days before admission he received iv corticosteroids as therapy for an episode of acute cellular rejection. Twelve hours after admission, a maculopapulous rash appeared on the trunk, arms and legs. A positive PCR for varicella virus DNA in the bronchoalveolar lavage confirmed the diagnosis of varicella pneumonitis. The patient received iv aciclovir and the pneumonitis resolved within 2 weeks. The clinical presentation of varicella infection in heart-transplanted patients is discussed.