User:Mr. Ibrahem/Eczema vaccinatum
| Eczema vaccinatum | |
|---|---|
 | |
| 8 month old with eczema vaccinatum after acquiring vaccinia from a sibling recently vaccinated for smallpox. | |
| Specialty | Infectious disease |
| Symptoms | Crops of small blisters, fever, swollen glands[1] |
| Complications | Scarring[2] |
| Usual onset | Sudden, 5 to 12 days post exposure[1][3] |
| Causes | Vaccinia[2] |
| Risk factors | Atopic dermatitis, other skin diseases[2] |
| Differential diagnosis | Eczema herpeticum, chickenpox, bacterial superinfection[4][3] |
| Treatment | Vaccinia immune globulin (VIG), antivirals[2] |
| Frequency | Rare[1][4] |
| Deaths | 35% without treatment, 7% with treatment[2] |
Eczema vaccinatum is a type of vaccinia infection, that may occur in people with atopic dermatitis (eczema) or other skin diseases.[2] Symptoms include a sudden onset of crops of small blisters, typically at sites of skin problems.[2] Typically there is also a fever and swollen glands.[1][5] Onset is 5 to 12 days post exposure.[3]
While it may occur due to direct smallpox vaccination with vaccinia; more often it occurs following spread from a household member who has had a recent vaccine.[2] While atopic dermatitis is a risk factor for the disease; it is estimated that if vaccinated, only one in a hundred would be affected.[4] The underlying mechanism involves extensive spread of the virus.[4] Diagnosis is usually based on exposure to vaccinia.[6]
Treatment is with vaccinia immune globulin (VIG) and potentially the antiviral medication cidofovir.[2][4] Prevention may include the use of the MVA-BN vaccine in those at high risk.[4] Scarring often remains after healing.[2] Without treatment around 35% die, and with treatment this is about 7%.[2]
Between 2002 and 2012 only one case was described in the United States.[4] In the United States in 1968 there were 66 cases following 14.5 million smallpox vaccinations, and 60 cases among several million contacts.[1] Males are affected twice as often as females.[3] The condition is believed to have been first described in 1882.[4]
References[edit]
- ^ a b c d e Petersen, Brett W.; Damon, Inger K. (2020). "348. Smallpox, monkeypox and other poxvirus infections". In Goldman, Lee; Schafer, Andrew I. (eds.). Goldman-Cecil Medicine. Vol. 2 (26th ed.). Philadelphia: Elsevier. p. 2183. ISBN 978-0-323-53266-2.
- ^ a b c d e f g h i j k James, William D.; Elston, Dirk; Treat, James R.; Rosenbach, Misha A.; Neuhaus, Isaac (2020). "19. Viral diseases". Andrews' Diseases of the Skin: Clinical Dermatology (13th ed.). Edinburgh: Elsevier. pp. 387–388. ISBN 978-0-323-54753-6. Archived from the original on 2022-06-03. Retrieved 2022-05-29.
- ^ a b c d Ruzicka, Thomas; Ring, Johannes; Przybilla, Bernhard (9 March 2013). Handbook of Atopic Eczema. Springer Science & Business Media. p. 58. ISBN 978-3-662-02671-7. Archived from the original on 28 June 2022. Retrieved 21 June 2022.
- ^ a b c d e f g h Reed, JL; Scott, DE; Bray, M (March 2012). "Eczema vaccinatum". Clinical infectious diseases : an official publication of the Infectious Diseases Society of America. 54 (6): 832–40. doi:10.1093/cid/cir952. PMID 22291103.
- ^ "Smallpox Vaccine Adverse Events: For Healthcare Providers | CDC". www.cdc.gov. 25 March 2021. Archived from the original on 28 June 2022. Retrieved 21 June 2022.
- ^ Cherry, James; Demmler-Harrison, Gail J.; Kaplan, Sheldon L.; Steinbach, William J.; Hotez, Peter (29 December 2017). Feigin and Cherry's Textbook of Pediatric Infectious Diseases. Elsevier Health Sciences. p. PT5359. ISBN 978-0-323-39281-5. Archived from the original on 28 June 2022. Retrieved 21 June 2022.