{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T20:43:23Z","timestamp":1791492203183,"version":"4.3.4"},"reference-count":23,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","license":[{"start":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T00:00:00Z","timestamp":1751328000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>\n                    A\n                    <jats:sc>BSTRACT<\/jats:sc>\n                  <\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>Despite a recent rise in incidence, varicella in adults remains under-recognized, particularly in tropical regions, where prevalence is high. This study aims to delineate the clinical spectrum, evaluate organ involvement, and assess outcomes in adult Indian patients with varicella.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A hospital-based retrospective study was conducted at Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India, between March 2016 and February 2020. Adult patients aged \u226515 years diagnosed with varicella were included. Diagnosis was based on the presence of a characteristic vesicular rash, epidemiological history of the recent exposure, and exclusion of alternative etiologies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Fifty patients (mean age 32 years, 31 males) were included. Organ dysfunction was seen in 34 (68%) patients, most commonly pneumonia (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 17), hepatitis (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 12), hemorrhagic complications (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 12), acute meningoencephalitis or myelitis (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 10). Multi-organ involvement was present in 12 (24%). In-hospital mortality was 18% (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 9), highest among patients with pneumonia (41.2%) and hemorrhagic complications (41.7%). Advanced age was the only independent predictor of mortality (OR 1.144,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      value 0.034). Twenty-three (46%) patients had underlying predisposing conditions, most commonly immunosuppressive therapy (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 9) and hematological malignancy (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 5). However, organ complications and outcomes were comparable regardless of the immune status. Only one case of breakthrough varicella was detected. Admissions peaked in March and April (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 15), although cases were seen throughout the year.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Varicella in adults is frequently associated with severe organ complications, particularly pneumonia, and substantial in-hospital mortality. These adverse outcomes occur even in previously healthy individuals, underscoring the need for heightened clinical vigilance, timely antiviral therapy, and strengthened preventive strategies in the adult population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/jfmpc.jfmpc_361_25","type":"journal-article","created":{"date-parts":[[2025,7,19]],"date-time":"2025-07-19T06:00:09Z","timestamp":1752904809000},"page":"2867-2872","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":3,"title":["Clinical spectrum and outcomes of adult varicella (chickenpox) in India"],"prefix":"10.4103","volume":"14","author":[{"given":"Ritin","family":"Mohindra","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Postgraduate Institute of Medical Education and Research, Nehru Hospital, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vidhi","family":"Singla","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Postgraduate Institute of Medical Education and Research, Nehru Hospital, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Navneet","family":"Arora","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Postgraduate Institute of Medical Education and Research, Nehru Hospital, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vikas","family":"Suri","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Postgraduate Institute of Medical Education and Research, Nehru Hospital, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashish","family":"Bhalla","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Postgraduate Institute of Medical Education and Research, Nehru Hospital, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashok K.","family":"Pannu","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Postgraduate Institute of Medical Education and Research, Nehru Hospital, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,7,21]]},"reference":[{"key":"R1-20250804","first-page":"265","article-title":"Varicella and herpes zoster vaccines: WHO position paper","volume":"89","year":"2014","journal-title":"Wkly Epidemiol Rec"},{"key":"R2-20250804","doi-asserted-by":"crossref","first-page":"1365","DOI":"10.1016\/S0140-6736(06)69561-5","article-title":"Varicella","volume":"368","author":"Heininger","year":"2006","journal-title":"Lancet"},{"key":"R4-20250804","doi-asserted-by":"crossref","first-page":"15016","DOI":"10.1038\/nrdp.2015.16","article-title":"Varicella zoster virus 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