BMJ Case Reports 2013; doi:10.1136/bcr-2013-008693

An ICU patient with spots and a peculiar pneumonia

  1. Lenneke E M Haas3
  1. 1Department of Internal Medicine, Diakonessenhuis Utrecht, Utrecht, The Netherlands
  2. 2Department of Microbiology, Diakonessenhuis Utrecht, Utrecht, The Netherlands
  3. 3Department of Intensive Care, Diakonessenhuis Utrecht, Utrecht, The Netherlands
  1. Correspondence to Lenneke Haas, lennekehaas{at}


This is the first report of varicella zoster virus (VZV) pneumonia in an adult patient treated with rituximab because of autoimmune haemolytic anaemia and it illustrates that a VZV infection should be considered when an immunocompromised patient develops pulmonary symptoms, even in the absence of cutaneous lesions. It also depicts the importance of performing varicella serology in patients receiving multiple immunosuppressive agents.

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