A 31-year-old man diagnosed as having varicella at another hospital was admitted to our hospital for pyrexia and breathlessness 3 days after the appearance of a rash. Multiple random micronodular opacities and infiltration on the chest computed tomography scan led us to diagnose varicella pneumonia. Bronchoscopy performed to differentiate secondary bacterial pneumonia from primary viral pneumonia showed white spotted lesions in the pharynx and trachea. Although varicella-zoster viral DNA was detected in bronchoalveolar lavage fluid, no bacteria were cultured from the lavage fluid. Therefore we diagnosed primary varicella pneumonia. Acyclovir and ampicillin and sulbactam were administered, and fever and respiratory failure improved. Micronodular opacities on the chest computed tomography scan disappeared 3 months after disease onset. We report this case mainly in regard to the radiologic and bronchoscopic findings.