LAUSR

A 60-year-old healthy woman presented to our hospital with a history of a fever and macular rash covering her whole body. She had no medical history of chickenpox or vaccination for chickenpox, and there was no clear history of contact with a chickenpox patient. The varicella-zoster IgG and IgM levels were <2.0 and 0.43, respectively. She was admitted to our hospital with a clinical diagnosis of chickenpox and was intravenously administered acyclovir. Four days after admission, vesicular rash and crusted papules appeared (Picture 1, 2). Her condition was resolved with antiviral therapy without any complications. Two weeks after discharge, the varicella-zoster IgG and IgM were 26.3 and 5.00, respectively, confirming adult chickenpox. Chickenpox is highly contagious, but its vaccine was not included among scheduled vaccines in Japan before September 2014. Therefore, some adults lack immunity to chickenpox. Chickenpox should be considered a potential diagnosis when an adult patient presents with macular rash, especially when the rash occurs in different stages. In addition, adult patients with chickenpox are more likely to have complications, such as pneumonia, than younger patients (1). Careful follow-up is required when a patient is diagnosed with adult chickenpox.