Diffuse pulmonary micronodules related to prior VZV infection

BACKGROUND/INTRODUCTION: Chickenpox is a common viral infection caused by Varicella-zoster virus (VZV). Pneumonia is an infrequent complication of chickenpox infection. Rarely, multiple calcified pulmonary nodules can be the sequela of healed VZV pneumonia. CASE PRESENTATION: A middle-aged female individual was found to have diffuse incidental pulmonary micronodules. By further history inquiry and diagnosis of exclusion, her pulmonary micronodules were determined to be likely associated with prior VZV infection. CONCLUSIONS: VZV infection can cause calcified pulmonary nodules related to granuloma, and gold standard diagnosis is surgical lung biopsy with VZV PCR. However, diagnosis of exclusion is a reasonable approach to reach a presumptive diagnosis. Familiarity with this entity can potentially avoid invasive procedures in selected patients.