Chickenpox and Other
Disease Comorbidities

What other disease is associated with chickenpox?

Chickenpox in CKD, Including Patients on Dialysis

  • When Chickenpox occurs in adult patients with kidney disease, it follows a deadly course and carries a very high risk of morbidity and mortality. Patients with kidney disease are more likely to develop shingles. Kidney patients non-immune to varicella (i.e., never had Chickenpox and/or are varicella seronegative) should be given two doses of vaccine 4–8 weeks apart or a second dose if they previously received only 1 dose. Infections contribute to as much as 30-36% of morbidity in patients on long-term dialysis.

Varicella Infection in Cancer Patients

  • The clinical presentation and complication rates of Chickenpox in cancer patients are similar to the normal population. Varicella infection while receiving chemotherapy can cause a therapy delay in 70% of the patients. There is also a higher risk of varicella infection in immunosuppressed adults. Children with leukemia and other malignancies receiving prolonged anticancer therapy run a high risk of contracting Chickenpox.

Chickenpox in Transplant Patients

  • Primary varicella infection/Chickenpox remains a potentially fatal infection in adult renal transplant recipients. It may present with complications ranging from allograft rejections, hepatitis, pancreatitis, pneumonia, and death. Attention should be directed towards prevention by the identification and immunization of at-risk patients before transplantation. Varicella vaccination in the high-risk groups, especially during the pre-ESRD stage, can possibly decrease the number of patients with varicella infection.

Chickenpox in Diabetic Patients

  • Patients with diabetes mellitus were associated with a 1.6-fold increased risk for the development of herpes zoster. Varicella showed a more aggressive course in diabetic patients compared to healthy individuals. It can increase the duration of illness in diabetic patients. Additionally, the incidence of undiagnosed diabetes is high among Chickenpox patients, which may be due to the impairment of immunity in diabetes. Hence, routine screening for diabetes mellitus in Chickenpox patients is recommended.
Lai et al. Medicine (Baltimore). 2021 Apr;100(16):e25292.