1/7. chickenpox pneumonia: case report and literature review.The incidence of primary chickenpox infection in young adults appears to be rising in the UK and other developed countries. The infection is more severe in adults than in children and complications, including pneumonia, are more frequent. An illustrative case of severe chickenpox pneumonia in an immunocompetent, non-pregnant adult smoker is presented. The epidemiology and pathology of the disease is discussed and a review of current management in the emergency department and the intensive care unit is presented. Strategies for the prevention of chickenpox pneumonia are also discussed.- - - - - - - - - - ranking = 1keywords = young adult (Clic here for more details about this article) |
2/7. Patterns of measles pneumonitis.As a result of the enlarging pool of unvaccinated children and young adults, there has been an increase in serious measles pneumonitis in our areas. We recently examined autopsy and/or lung biopsy material from five children with fatal measles pneumonitis. Two patients were immunocompromised because of either prematurity or acute leukemia and died 13-16 days following onset of symptoms. Both had classic giant cell pneumonitis, with readily demonstrable intranuclear inclusions. Three other children without known immunocompromise had a more prolonged course. The lungs of these patients lacked the classic pattern and displayed instead a spectrum of less specific findings ranging from organizing diffuse alveolar damage to interstitial pneumonia with giant cells, but without viral inclusions. An accompanying necrotizing bronchiolitis was also present. Electron microscopy and/or detection of elevated measles-specific immunoglobulin M was necessary to confirm the diagnosis in these apparently immunocompetent patients. We conclude that the histologic features of fatal or serious measles pneumonitis are variable and depend to some extent on the immunocompetence of the host as well as the duration and tempo of the disease. Ancillary studies may be necessary to establish the diagnosis in cases lacking classic histopathologic features.- - - - - - - - - - ranking = 1keywords = young adult (Clic here for more details about this article) |
3/7. Fulminant varicella infection complicated with acute respiratory distress syndrome, and disseminated intravascular coagulation in an immunocompetent young adult.Primary varicella infection in immunocompetent adults is very rare, but it has a high mortality rate because of serious complications. We describe a case of varicella infection in a previously healthy young adult complicated with acute respiratory distress syndrome (ARDS), rhabdomyolysis, acute hepatitis and disseminated intravascular coagulation (DIC). acyclovir was administered for varicella infection and the ARDS was successfully treated with steroidpulse therapy, hemofiltration and a mechanical respiratory support with a positive end-expiratory pressure. Early administration of antiviral agents and extensive management were thought to be necessary for such patients with severe complications.- - - - - - - - - - ranking = 1keywords = young adult (Clic here for more details about this article) |
4/7. Adult respiratory distress syndrome secondary to varicella infection in a young adult.A case is described of chickenpox in a young non-immunosuppressed adult, resulting in adult respiratory distress syndrome and hepatitis, which was successfully managed with artificial ventilation and vidarabine.- - - - - - - - - - ranking = 4keywords = young adult (Clic here for more details about this article) |
5/7. Severe respiratory insufficiency complicating Epstein-Barr virus infection: case report and review.We report a case involving a young adult who had life-threatening bilateral pneumonitis in the course of an acute Epstein-Barr virus (EBV) infection. Because of severe hypoxemia, the patient required mechanical ventilation and additional oxygenation by an intravascular oxygenator. The patient was treated with corticosteroids and survived without sequelae. Severe pulmonary involvement associated with EBV infection is a rare but potentially fatal complication of infectious mononucleosis. Similar cases reported in the literature are reviewed, and the therapeutic options for this particular complication are discussed.- - - - - - - - - - ranking = 1keywords = young adult (Clic here for more details about this article) |
6/7. Severe viral pneumonia in young adults.Three patients with primary group-A influenzal pneumonia had diffuse pulmonary infiltrates, arterial oxygen tensions (PaO2) less than 50 mm Hg while breathing oxygen at 1 atm (fractional concentration of oxygen in the inspired gas (FIo2) equals 1.0), and right-to-left pulmonary shunts greater than 45 percent of total pulmonary blood flow. At an FIo2 of 1.0, end-expiratory pressure (EEP) was added in increments of 2 to 5 cm H2O every 30 to 60 minutes until the PaO2 was above 200 mm Hg and right-to-left shunting had fallen to less than 25 percent. The FIo2 was then lowered to 0.5. Using this systematic approach, all three patients required an FIo2 of 1.0 for less than 12 hours, minimizing the risk of oxygen toxicity. Two of the three patients did not require mechanical ventilation and breathed spontaneously while on continuous positive airway pressure (CPAP), and one of them tolerated an EEP of 31 cm H2O. Two patients survived, and one died of a neurologic complication of cardiopulmonary arrest, despite clearing on the chest x-ray film and improved gas exchange. Therapy with CPAP can be safely used in adults and has practical as well as theoretic benefits over continuous positive-pressure ventilation.- - - - - - - - - - ranking = 4keywords = young adult (Clic here for more details about this article) |
7/7. Varicella-related deaths among adults--united states, 1997.During January-April 1997, state health departments reported three fatal cases of varicella (chickenpox) to CDC. All three cases occurred in young adult women who were unvaccinated and susceptible to varicella and who were infected by exposure to unvaccinated preschool-aged children with typical cases of varicella. This report summarizes these three cases, which indicate that preventable varicella-related deaths continue to occur in the united states. In addition, the report re-emphasizes the recommended strategies for preventing varicella.- - - - - - - - - - ranking = 1keywords = young adult (Clic here for more details about this article) |