A 24 year old male presents with worsening cough and breathlessness and a 3 day history of an itchy rash predominantly over his torso.
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Describe and interpret this CXR and clinical images
There is are bilateral mid zone nodular infiltrates, predominantly affecting the upper lobes.
There is a vesicular rash over the torso, arms and face.
The lesions are of different stages: macules, papules and vesicles.
This is acute varicella infection (chicken pox) with varicella pneumonitis.
Varicella pneumonia can occur in up to 1:400 cases of immune competent adults and carries a mortality of up to 30%.
Prompt administration of intravenous acyclovir is associated with clinical improvement.