Smoking and varicella pneumonia

Letters to the Editor

3 I2

Smoking and varicella p n e u m o n i a Accepted for publication x I November I987 Sir, Increasing awareness of an association between cigarette smoking and many pulmonary disorders prompted us to examine the incidence of cigarette smoking among adults admitted to our hospital with varicella and to relate this to the incidence of varicella pneumonia. During the period from I98o to I986, 98 patients aged 20 years or older were admitted to Fairfield Hospital, Melbourne, with the clinical diagnosis of variceUa. Cases of herpes zoster were not included in the study. T w e n t y patients had welldescribed risk factors for the development of severe varicella, such as pregnancy (seven), malignant disease (seven), use of immunosuppressive agents (four) and severe chronic illness (two). All patients in the study had a chest X ' r a y . O f the 78 previously healthy patients, I9 had clinical and radiological evidence of pneumonitis, while 59 had no evidence of lung involvement. T h e median age of both these groups was 32 years. A history of cigarette smoking was sought from 67 patients. A X2 test showed a Statistically significant association (P < o.ooI) between cigarette smoking and the development of pneumonitis (see Table I). T h e relative risk of developing pneumonitis in smokers with varicella was I5 times that of non-smokers with the same disease. T h e s e results help to explain the previously reported observation that smokers form the majority of patients with radiological evidence of pulmonary calcification after adult varicella. 1 Table I Smokers Varicella with pneumonitis Varicella without pneumonitis

Fairfield Hospital Yarra Bend Road Melbourne 3078, Australia

I6 I8

Non-smokers Unknown I 32

2 9

Total 19 59

M. L. Grayson H. Newton-John

Reference I. Knyvett AF. The pulmonary lesions of chickenpox. Q J Ailed I966; I39: 313-23.

Correspondence to H. Newton-John.