ARDS in Chicken Pox Pneumonia; Is Co Morbidity Really a Contributing Factor?

Abstract

Introduction: Chicken Pox is stated to be the most contagious disease of childhood. Incidence of varicella in adults is on rising trend and it’s a source of morbidity and mortality in adult population. Out of various complications of chicken pox, pneumonia is the most common and frequent complication in healthy adults. The mortality rate for patients with chicken pox pneumonia varies from 10% to 33% but in patients needing mechanical ventilation, it may approach 50%. Various risk factors have been studied for development of varicella pneumonia. These include male gender, smoking, chronic lung disease, immunosuppression, pregnancy, history of contact with a patient with chicken pox, severity of skin rash and time of presentation to the hospital may also be relevant. Objectives: To determine the frequency of different risk factors in patients with chicken pox pneumonia presenting in Allied Hospital Faisalabad. Study Design: Cross Sectional Descriptive Study. Setting: Medical Unit II, Allied Hospital Faisalabad. Duration: The data was collected from 1st January 2017 to 30 September 2017. Methodology: A retrospective chart review of adult patients (16 years old and above) both male and female with diagnosis of Varicella Pneumonia was conducted. Age; sex; clinical presentation; smoking history; duration between onset of disease and presentation to hospital; history of co-morbid factors; as well as outcomes was documented in these patients. The data was analyzed using SPSS version 12.0 statistical software. Frequency and percentages were calculated for the risk factors of pneumonia, gender of the patients and patients needing ventilator therapy. Results: 27 patients out of 343 patients with chicken pox developed varicella pneumonitis All the patients with pneumonia went into ARDS (100%). 25 patients (92.6%) needed ventilatory support. 23 out of 27 patients were male. Smoking was found to be a risk factor in 48.1% patients. 3 patients (11.1%) were immunocompromised. 55.5% of the patients (15 out of 27) were late presenters. Conclusion: Effect and Impact of different co-morbidities on patients of chicken pox is important not only for medical professional but also for general public in order to prevent life threatening complication like pneumonia initiating treatment early and timely referral to tertiary care hospital for proper management