Varicella-zoster Virus Reactivation with Severe Pneumonia Following Convalescence from Coronavirus Disease: A Case Report and Literature Review

An association between coronavirus disease 2019 (COVID-19) and concomitant varicella-zoster virus (VZV) reactivation has been proposed. We herein report a case of severe VZV pneumonia in a 73-year-old man who underwent corticosteroid tapering after recovering from COVID-19 and presented with fever, vesicular rashes, and hypoxemia. Chest computed tomography revealed ground-glass opacities (GGOs) and multiple granular shadows. Varicella-zoster virus was detected in the skin and bronchoalveolar lavage fluid. The patient was diagnosed with disseminated VZV reactivation and thereafter successfully recovered with acyclovir treatment. Physicians should consider the possibility of VZV reactivation when GGOs or patchy nodular shadows appear during the course of patients with COVID-19.