Abstract
Varicella pneumonia is a rare but serious complication of the infection with the common varicella-zoster virus. This is typically seen in immunocompromised individuals; however, it can also occur in immunocompetent adults. We report this case of a previously healthy middle-aged male smoker who presented with a vesicular rash and rapidly developed signs of respiratory distress. LEARNING POINTS: Varicella pneumonia can occur in immunocompetent individuals, particularly in high-risk groups such as smokers and pregnant females.Early recognition and initiation of intravenous acyclovir is the cornerstone of treatment and is associated with reduced mortality. This case also highlights the importance of offering maximum ventilatory support in those who develop respiratory failure.The role of adjunctive corticosteroids remains controversial. There is limited evidence suggesting that they may reduce intensive care stay in severe cases, however, current data is limited.This case highlights the importance of varicella vaccination in adults without prior immunity.