Generalized Vaccinia in an Active Duty Service Member: One of the Many Faces of Smallpox Vaccine-Related Cutaneous Adverse Reactions
59th Medical Wing San Antonio United States
Pagination or Media Count:
A 21-year-old active duty male without history of skin disease presented with new onset pruritic, vesicular rash on the bilateral upper and lower extremities, trunk, and anogenital area beginning 1 week after pre-deployment smallpox vaccination to the left deltoid. Review of systems was significant for mild headache and malaise. Physical exam revealed coalescing annular, erythematous papules and plaques in multiple body locations. The patient was admitted to the hospital for several days for control of rash-associated pain and pruritus. Punch biopsy of rash on the right trunk was obtained, and swab from the left shoulder was positive for vaccinia virus by PCR. The rash distribution and positive vaccinia culture away from the inoculation site yielded a diagnosis of generalized vaccinia. The patient recovered without complications over the next few weeks with supportive care. If the patient were immunosuppressed or systemically ill, vaccinia immune globulin or a systemic antiviral would have been considered.
- Medicine and Medical Research