Pulmonary Infarction With Chickenpox

To the Editor. — Glick et al (222:173, 1972) described pulmonary infarction in a patient with varicella pneumonia. Embolic lesions no doubt occur in patients with varicella infections, and the authors cite evidence that suggests that intravascular coagulation is common. It should be emphasized that infarction is one of the primary morphologic lesions observed in visceral and cutaneous herpetic infections, whether due to zoster or varicella. At the light microscopic level, I have observed infarction whenever the infection penetrates epithelium or involves a parenchymal organ. The initiating lesion seems to be the viral vasculitis to which the authors refer. In fact, after careful study of these lesions, it appears that the vessel itself becomes necrotic and that this feature plus any local clotting leads to infarction. Consequently, infarction is not an unexpected consequence of varicella pneumonia, and probably occurs at differing times in various parts of the lungs as the infection evolves