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Ten days after being vaccinated against smallpox, a 27-year-old man was hospitalized with a high fever, facial edema, and an umbilicated, vesicular, crusting rash on his face, neck, upper chest, and hands (Panel A). He had a history of atopic dermatitis. Eczema vaccinatum was diagnosed. As the vesicular rash became disseminated, supraglottic edema with shortness of breath developed. The patient was transferred to the intensive care unit and received vaccinia immune globulin and supportive care. Over the next two weeks extensive crusting of the facial lesions occurred (Panel B). Cultures of vesicular fluid grew vaccinia virus, and skin biopsy showed . . . [Full Text of this Article] |
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