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Shortness of breath

Q1: What is the diagnosis?
Varicella zoster virus (VZV) or chickenpox pneumonitis.

Q2: How might the diagnosis be confirmed?
Diagnosis can be made in most circumstances clinically. Confirmation and identification of the virus can be made in a number of ways using laboratory tests:

• Polymerase chain reaction—With high sensitivity (97%–100%) and specificity for viral DNA with rapid diagnosis time, this is a useful test, as it can be applied to most clinical specimens and is likely to replace older tests.¹
  
• Serology—Anti-VZV IgM can be used to detect active disease, while the presence of anti-VZV IgG is a marker of previous infection/inoculation.
  
• Electron microscopy—This is very sensitive but expensive and unable to differentiate between VZV and other herpes viruses—for example, herpes simplex virus (HSV).
  
• Viral culture—This is the gold standard for establishing the diagnosis, though VZV is more difficult to culture than HSV.
  
• Tzanck smear—An inexpensive "bedside" test from vesicular fluid with a sensitivity reported at 80%–100%.² Under . . . [Full text of this article]