Eczema vaccinatum is a very rare, but potentially life-threatening reaction seen after exposure to vaccinia virus which is used for smallpox vaccination. It can be either a consequence of vaccination or can occur after direct contact with vaccinated individuals. A history of atopic dermatitis is predisposes to this disorder. The appearance of vesicles and pustules, as well as systemic symptoms such as fever and malaise, constitute the clinical presentation. Clinical and microbiological studies are needed to make the diagnosis.
Presentation
As the World Health Organization (WHO) had declared the eradication of smallpox in 1979 after successful global immunization, the use of vaccinia virus in the prophylaxis of humans was not carried out until the beginning of the 21st century, when smallpox was considered to be a possible biological weapon [1] [2]. Consequently, the United States and several other countries have reintroduced vaccination of military personnel and certain at-risk individuals, which led to reports of various complications and adverse reactions, one of them being eczema vaccinatum [1] [2] [3] [4]. Although seen only in a handful of cases, patients develop eczema vaccinatum shortly after vaccination or after direct contact with recently vaccinated individuals [1] [2] [3] [5] [7]. Studies have confirmed that the main predisposing factor (and a contraindication) for this cutaneous disorder is the presence of atopic dermatitis (or some other type of dermatitis) [1] [2] [4] [5] [6]. The abrupt onset of vesicles, pustules, and erosions in same stages approximately 3-14 days after being in contact with the vaccinia virus is the hallmark of eczema vaccinatum [2]. Lesions that are seen on the skin are commonly superinfected (predominantly by Staphylococcus aureus), while corneal lesions may also develop, potentially leading to corneal ulceration and even blindness [2]. Furthermore, fever, lymphadenopathy, and malaise can accompany skin lesions [2]. In addition to cutaneous and ocular disorders, life-threatening subglottic edema is a possible complication [2], implying that early recognition is vital.
Entire Body System
- Fever
Definition 1: a now rare complication of vaccinia superimposed on atopic dermatitis with high fever and generalized vesicles and papulovesicles - [noun denoting state] Synonyms for eczema vaccinatum in the sense of this definition kaposi's varicelliform [wordfocus.com]
Figure 1 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). [nejm.org]
The appearance of vesicles and pustules, as well as systemic symptoms such as fever and malaise, constitute the clinical presentation. Clinical and microbiological studies are needed to make the diagnosis. [symptoma.com]
Princeton's WordNet (0.00 / 0 votes) Rate this definition: eczema vaccinatum, Kaposi's varicelliform eruption (noun) a now rare complication of vaccinia superimposed on atopic dermatitis with high fever and generalized vesicles and papulovesicles Freebase [definitions.net]
- Military Personnel
As military personnel are predominantly mentioned in the reports, the patient's occupation (or their parents') should be evaluated. [symptoma.com]
Smallpox was officially declared eradicated by the World Health Organization in 1979, and inoculation of military personnel was suspended in 1990. [nytimes.com]
In partnership with the Association of Military Dermatologists Cutis. 2018 February;101(2):87-90 In 2002, the United States implemented a new program for smallpox vaccinations among military personnel using a live vaccinia virus product. [mdedge.com]
Vaccinia is used to vaccinate military personnel and health care workers against smallpox. The source of this child's infection was his father, who had been vaccinated in late January in preparation for military deployment. [uchicagomedicine.org]
The U.S. government reinstated smallpox vaccination for military personnel and selected healthcare workers because of fears the virus could be used in a biological attack. “The U.S. [reuters.com]
- Swelling
About Eczema 497,024 discussions Eczema is a term for several different types of skin swelling. Eczema is also called dermatitis. [treato.com]
Psoriasis is also an immune-mediated skin disease, and is characterized by scaling skin and inflammation (pain, swelling, heat, and redness). Most psoriasis cause patches of thick, red skin with silvery scales. These patches can itch or feel sore. [clinicaltrials.gov]
Floor 3 909 Fulton St. by such symptoms as hyperemia of eyelids skin swelling rash (sometimes bullous) headache weakness fever itching. Allergic *Face neck and extensor in infants. [zvonilka.eu]
Eczema is a term for several different types of skin swelling. Get information on atopic dermatitis a type of eczema home remedies causes symptoms diagnosis management treatment and medications. Most types cause dry itchy skin and. [eczema-prevent.blogspot.com]
Other symptoms typically include: discolored and inflamed skin dry skin thickened patches of scaling skin swelling crusting or oozing Someone with eczema can have all or a few of these symptoms, depending on the type of eczema. [medicalnewstoday.com]
- Anorexia
Transient Amnesia Generalized cerebral edema Mild lymphocytic meningeal infiltration Widespread ganglion dengerative changes 13 Post-Vaccinial Encephalomyelitis Older than 2 years 11-15 days after vaccination Fever Vomiting Headache Malaise Anorexia [slideplayer.com]
Respiratoric
- Pneumonia
Mechanisms of immune adaptation in newborn infants with intrauterine pneumonia/Beniova SN Polyakov MS OV Nevmerzhitskaya et al.//Medical immunology -2008 – Vol.10, № 4-5. [optimization-nation.com]
Gastrointestinal
- Vomiting
3 4 5 Progressive Vaccinia 6 7 Enlarged Site vs PV Large Reaction Differentiation 8 Enlarged Site vs PV Large Reaction Differentiation 9 Progressive Vaccinia 10 Post-Vaccinial Encephalitis Diagnosis Cerebral or cerebellar dysfunction Headache Fever Vomiting [slideplayer.com]
Clinical symptoms reflect cerebral or cerebellar dysfunction with headache, fever, vomiting, altered mental status, lethargy, seizures, and coma. [cdc.gov]
The usual dose is 0.6 mL per kg intramuscularly or 100 to 500 mg per kg intravenously.8 Adverse reactions to VIG include local site reactions, nausea, vomiting, fever, aseptic meningitis and, rarely, anaphylaxis.8 VIG is administered under an investigational [aafp.org]
Sometimes severe abdominal pain and vomiting occur. After the prodrome, maculopapular lesions develop on the oropharyngeal mucosa, face, and arms, spreading shortly thereafter to the trunk and legs. The oropharyngeal lesions quickly ulcerate. [merckmanuals.com]
Then symptoms are flu-like, progressing from a high fever, cough, and fatigue to headache, backache, and other body aches with occasional vomiting and disorientation. [backwoodshome.com]
Skin
- Dermatitis
Pruritis (dominant symptom) Dermatitis - flexor surfaces Dermatitis is chronic or recurrent Family hx atopy Onset by age 7 Skin changes: Children: pruritic, red patches + scaling; face, scalp, extremities, trunk may be involved. [hopkinsguides.com]
The atopic dermatitis and eczema vaccinatum models we present here, are the first to simulate the severity of the diseases in humans. [ncbi.nlm.nih.gov]
Get information on atopic dermatitis a type of eczema home remedies causes symptoms diagnosis management treatment and medications. Dermatitis also known as eczema is a group of diseases that results in inflammation of the skin. [eczema-prevent.blogspot.com]
- Eruptions
Definition 1: a now rare complication of vaccinia superimposed on atopic dermatitis with high fever and generalized vesicles and papulovesicles - [noun denoting state] Synonyms for eczema vaccinatum in the sense of this definition kaposi's varicelliform eruption [wordfocus.com]
Dermatitis Vaccinica (Kaposi's Varicelliform Eruption). Arch. Dermat. & Syph. 1943; 47: 613 Scopus (10) Crossref Google Scholar Lane C.W. Herold W.C. Kaposi's Varicelliform Eruption. Arch. [jpeds.com]
Synonyms eczema Kaposi's varicelliform eruption eruption Antonyms inactiveness inaction inactivity 2. eczema noun. (ˈɛksəmə) Generic term for inflammatory conditions of the skin; particularly with vesiculation in the acute stages. [synonym.com]
Postvaccinal eruptions, according to Danziger,1 were first collectively studied and classified in 1881 by Behrend, who described erythematous, urticarial and herpetic dermatoses as well as the pustular eruptions termed vaccine generalisée by various French [jamanetwork.com]
· Lipschütz ulcer · Eruptive pseudoangiomatosis · Viral-associated trichodysplasia · Gianotti–Crosti syndrome M: VIR virs(prot)/clss cutn/syst (hppv/hiva, infl/zost/zoon)/epon drug(dnaa, rnaa, rtva, vacc) M: INT, SF, LCT anat/phys/devp noco(i/b/d/q/u [dictionnaire.sensagent.leparisien.fr]
- Skin Disease
It sometimes occurred in other skin diseases with barrier abnormalities. [medscape.com]
CONTINUE SCROLLING OR CLICK HERE FOR RELATED SLIDESHOW SLIDESHOW Rosacea, Acne, Shingles: Common Adult Skin Diseases See Slideshow [medicinenet.com]
Synonyms skin disease dermatitis chronic eczema allergic eczema disease of the skin skin disorder Kaposi's varicelliform eruption lichtenoid eczema eczema vaccinatum eczema hypertrophicum eczema herpeticum Etymology eczema (English) ἔκζεμα (Ancient Greek [synonym.com]
Clearly documenting the morphology, extent of disease involvement (eg, body surface area), treatment plan, response to treatment, and exacerbating factors will aid in ensuring the patient’s medical record accurately reflects their skin disease. [mdedge.com]
People with other skin diseases (such as atopic dermatitis, burns, impetigo, or herpes zoster ) also have an increased risk of contracting eczema vaccinatum and should not be vaccinated against smallpox. [dict.eudic.net]
- Skin Rash
Eczema vaccinatum is a serious, potentially life-threatening skin rash caused by widespread dissemination of vaccinia virus with an ensuing infection of the skin. [sciencephoto.com]
It's characterized by serious local or disseminated, umbilicated, vesicular, crusting skin rashes in the face, neck, chest, abdomen, upper limbs and hands, caused by widespread infection of the... (36 of 889 words, 1 image) en.wikipedia.org/wiki/Eczema [memidex.com]
It is characterized by serious local or disseminated, umbilicated, vesicular, crusting skin rashes in the face, neck, chest, abdomen, upper limbs and hands, caused by widespread infection of the skin in people with previous diagnosed skin conditions such [dict.eudic.net]
- Blister
blisters on the edges of the fingers, toes, palms, and soles of the feet. [everydayhealth.com]
Vaccinia virus was isolated from the blister fluid in both cases. The mother was treated with hyperimmune anti‐vaccinial gamma‐globulin and N‐methylisatin β‐thiosemicarbazone (MarboranR). Both patients recovered. [onlinelibrary.wiley.com]
Atopic dermatitis leads to the rapid appearance of poorly circumscribed erythema, papulovesicles, or blisters, often with weeping areas. [aafp.org]
People with eczema and immune conditions can develop a serious reaction if they are vaccinated or come into contact with the blisters of a vaccinated person. The soldier received the vaccine even though he had a history of skin allergies. [reuters.com]
Penetration of the medication is enhanced by occlusion or presoaking in a tub of plain water followed immediately (without drying) by application. ...Read more Deshidrotic Eczema (Definition) A condition in which tiny, fluid-filled, itchy blisters appear [healthtap.com]
Neurologic
- Rabies
Author information 1 Poxvirus and Rabies Branch, Division of Viral and Rickettsial Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA. [email protected] Abstract On March 3, 2007, a 2-year-old boy was hospitalized with eczema [ncbi.nlm.nih.gov]
They can be used preexposure (eg, for hepatitis A), postexposure (eg, for rabies or hepatitis), and for treating disease (eg, eczema vaccinatum). [context.reverso.net]
Med Ctr, Infect Control Program, Chicago, IL 60637 USA Univ Chicago, Med Ctr, Dermatol Sect, Chicago, IL 60637 USA Univ Chicago, Med Ctr, Dept Pathol, Chicago, IL 60637 USA Chicago Dept Publ Hlth, Chicago, IL USA Ctr Dis Control & Prevent, Poxvirus & Rabies [accessdata.fda.gov]
Inger Damon, chief of the CDC's poxvirus and rabies branch. Damon has been involved in the daily conference calls on the boy's treatment. [articles.chicagotribune.com]
Specimens (swabs, lesion biopsy tissue, and/or sera) can also be sent to the Centers for Disease Control (CDC) Poxvirus and Rabies Branch for vaccinia species confirmation, culture and serologic response (which are important in heralding patient recovery [infectiousdiseaseadvisor.com]
- Headache
Eczema Vaccinatum 2 3 4 5 Progressive Vaccinia 6 7 Enlarged Site vs PV Large Reaction Differentiation 8 Enlarged Site vs PV Large Reaction Differentiation 9 Progressive Vaccinia 10 Post-Vaccinial Encephalitis Diagnosis Cerebral or cerebellar dysfunction Headache [slideplayer.com]
The most common side effects of ACAM2000 are itching, swollen lymph nodes, sore arm, fever, headache, body aches, mild rash, and fatigue. There was no significant difference in the rate of serious adverse events. [cidrap.umn.edu]
Studies completed in the 1960s, before widespread vaccination was discontinued, found that most people have either no symptoms or mild side effects such as fever or headaches when exposed to vaccinia during vaccination. [uchicagomedicine.org]
The incubation period, followed by headache and body pains, are similar to ordinary smallpox. [backwoodshome.com]
Clinical symptoms reflect cerebral or cerebellar dysfunction with headache, fever, vomiting, altered mental status, lethargy, seizures, and coma. [cdc.gov]
- Lethargy
Enlarged Site vs PV Large Reaction Differentiation 8 Enlarged Site vs PV Large Reaction Differentiation 9 Progressive Vaccinia 10 Post-Vaccinial Encephalitis Diagnosis Cerebral or cerebellar dysfunction Headache Fever Vomiting Altered mental status Lethargy [slideplayer.com]
Clinical symptoms reflect cerebral or cerebellar dysfunction with headache, fever, vomiting, altered mental status, lethargy, seizures, and coma. [cdc.gov]
The following summarizes the Neff criteria: • Encephalitis: post-vaccinial central nervous system involvement, including separately or in combination, the following symptoms: meningeal signs, ataxia, muscular weakness, paralysis, lethargy, coma or convulsions [bmcpublichealth.biomedcentral.com]
- Meningism
Elevated CSF protein Post-Vaccinial Encephalitis Diagnosis 12 Post-Vaccinial Encephalopathy Infants under 2 years Acute onset 6-10 days post-vaccination Seizures Hemiplegia Aphasia Transient Amnesia Generalized cerebral edema Mild lymphocytic meningeal [slideplayer.com]
The usual dose is 0.6 mL per kg intramuscularly or 100 to 500 mg per kg intravenously.8 Adverse reactions to VIG include local site reactions, nausea, vomiting, fever, aseptic meningitis and, rarely, anaphylaxis.8 VIG is administered under an investigational [aafp.org]
The following summarizes the Neff criteria: • Encephalitis: post-vaccinial central nervous system involvement, including separately or in combination, the following symptoms: meningeal signs, ataxia, muscular weakness, paralysis, lethargy, coma or convulsions [bmcpublichealth.biomedcentral.com]
- Altered Mental Status
mental status Lethargy Seizures Coma 11 Central nervous system lesions Cerebrum Medulla Spinal cord Lumbar Puncture Increased opening CSF Monocytosis Lymphocytosis Elevated CSF protein Post-Vaccinial Encephalitis Diagnosis 12 Post-Vaccinial [slideplayer.com]
Clinical symptoms reflect cerebral or cerebellar dysfunction with headache, fever, vomiting, altered mental status, lethargy, seizures, and coma. [cdc.gov]
Workup
Given the rare occurrence of eczema vaccinatum in clinical practice, the diagnosis may not be easy. For this reason, physicians must obtain a thorough patient history that will assess the course and progression of symptoms, the presence of preexisting skin diseases, and if family members or close relatives/friends (or the patient him/herself) have been recently vaccinated for smallpox. As military personnel are predominantly mentioned in the reports [1] [2] [4], the patient's occupation (or their parents') should be evaluated. A detailed physical examination is equally important, as the abrupt onset of typical lesions has a very narrow differential diagnosis. Microbiological studies, however, are necessary to confirm eczema vaccinatum. Molecular methods that detect viral genetic material - polymerase chain reaction (PCR) are recommended tests for identifying vaccinia virus in skin biopsy samples, swabs from the lesions or from the skin of an open vesicle [1] [2]. Moreover, the specific finding of Guarnieri bodies (intracytoplasmic inclusions) on histological examination is useful in making the diagnosis [2]. Thus, a microbiological investigation should be initiated as soon as clinical suspicion is raised.
Serum
- Lymphocytosis
Encephalitis Diagnosis Cerebral or cerebellar dysfunction Headache Fever Vomiting Altered mental status Lethargy Seizures Coma 11 Central nervous system lesions Cerebrum Medulla Spinal cord Lumbar Puncture Increased opening CSF Monocytosis Lymphocytosis [slideplayer.com]
- Monocytosis
Post-Vaccinial Encephalitis Diagnosis Cerebral or cerebellar dysfunction Headache Fever Vomiting Altered mental status Lethargy Seizures Coma 11 Central nervous system lesions Cerebrum Medulla Spinal cord Lumbar Puncture Increased opening CSF Monocytosis [slideplayer.com]
Treatment
Vaccinia immune globulin (VIG): licensed by FDA for treatment complications of vaccinia immunization. EV is a VIG CDCclear indication for urgent use. Early treatment may be life-saving. [hopkinsguides.com]
And Prevention Of Eczema Vaccinatum In Atopic Atopic Dermatitis Treatment Pictures Home Remedies Causes Generalized Vaccinia Progressive Vaccinia And Eczema Vaccinatum Smallpox Vaccination And Adverse Reactions Induction Treatment And Prevention Of Eczema [eczema-prevent.blogspot.com]
[…] the treatment of orthopoxvirus infection. [ncbi.nlm.nih.gov]
Costs of Different Psoriasis Treatments: A Retrospective Cohort Study of the. My wife already taking treatment from Pantajali Surat. [zvonilka.eu]
Prognosis
While it is a well known entity to the specially trained dermatologist and pediatrician, the average physician's knowledge of this disease is not commensurate with the importance of his potential rôle in its causation or with the relatively serious prognosis [annals.org]
Etiology
The etiology is unknown, though the familial tendency is well documented. [nejm.org]
Professional Edition Eczema Symptoms And Diagnosis Everyday Health Dermatitis Wikipedia Atopic Dermatitis Practice Essentials Background Pathophysiology Eczema Symptoms And Diagnosis Everyday Health Kaposi Varicelliform Eruption Background Pathophysiology Etiology [eczema-prevent.blogspot.com]
Lancet. 1942; 2: 667 Abstract Google Scholar Thompson Richard General Review; the Etiology of Postvaccinial Encephalomyelitis. Arch. Path. 1931; 12: 601 Google Scholar Clouston T.M. Quin B.H. Report of Cases; a Case of Post-vaccinal Myelitis. M. J. [jpeds.com]
Epidemiology
Author Affiliations * Instructor in epidemiology, Harvard School of Public Health; district health officer, Massachusetts Department of Public Health. Facebook Twitter LinkedIn Email Copy URL Permissions [nejm.org]
In each of these chapters, a short discussion of the epidemiology of the disease and the history of immun isation against it is followed by a description of the vaccine, its efficacy, contraindications to its use and future developments. [books.google.ro]
Human herpes simplex virus infections: epidemiology, pathosgenesis, symptomatology, diagnosis, and management. [journals.healio.com]
The epidemiology of atopic dermatitis. Clin Dermatol. 2003;21(2):109–115. doi:10.1016/S0738-081X(02)00360-7 [CrossRef] Horii K, Simon S, Liu D, Sharma V. [healio.com]
Pathophysiology
Eczema Symptoms And Diagnosis Everyday Health Kaposi Varicelliform Eruption Background Pathophysiology Etiology Complicacoes Decorrentes Da Vacinacao Antivariolica A Eczema Rostrum Smallpox Vaccination Risk Considerations For Patients With Eczema Vaccinatum [eczema-prevent.blogspot.com]
Despite much current research interest, the pathophysiology of these disorders and their optimum treatment remain uncertain. [books.google.ro]
Two pathophysiologic mechanisms have been proposed to explain the increased propensity of persons with AD to develop bacterial and viiral infections. [grantome.com]
Eczema pathophysiology: T cell immune defect + atopy with high IgE (85%). Prevalence: 6-22% of the general population has eczema or prior hx; many more misdiagnosed. [hopkinsguides.com]
We then discuss current concepts of the pathophysiology of AD, noting how defective skin barrier function, epidermal hyperplasia, and abnormal immune responses favor the spread of poxviral infection, and identify a number of unanswered questions about [ncbi.nlm.nih.gov]
Prevention
Of Eczema Vaccinatum In Atopic Atopic Dermatitis Treatment Pictures Home Remedies Causes Generalized Vaccinia Progressive Vaccinia And Eczema Vaccinatum Smallpox Vaccination And Adverse Reactions Induction Treatment And Prevention Of Eczema Vaccinatum [eczema-prevent.blogspot.com]
WASHINGTON (Reuters) - A two-year-old boy who developed a serious reaction to his father’s smallpox vaccination has recovered but disease detectives found infectious virus all over his house, the Centers for Disease Control and Prevention reported on [reuters.com]
JAK inhibitors send messages to certain cells to prevent them from causing inflammation. Calcineurin inhibitors: A person may apply these to the skin to prevent eczema flare-ups and reduce inflammation. [medicalnewstoday.com]
To prevent eczema vaccinatum, vaccination should not be performed in patients with eczema and they should not be in contact with vaccines, if smallpox is not an immediate risk. [medicinenet.com]
Poxvirus & Rabies Branch, Atlanta, GA USA Ctr Dis Control & Prevent, Div Bioterrorism Preparedness & Response, Atlanta, GA USA Univ Arizona, Tucson, AZ USA Univ Colorado, Denver, CO 80202 USA SIGA Technol, Corvallis, OR USA US FDA, Washington, DC 20204 [accessdata.fda.gov]
References
- Vora S, Damon I, Fulginiti V, et al. Severe eczema vaccinatum in a household contact of a smallpox vaccinee. Clin Infect Dis. 2008;46(10):1555-1561.
- Jen M, Chang MW. Eczema herpeticum and eczema vaccinatum in children. Pediatr Ann. 2010;39(10):658-664.
- Moses AE, Cohen-Poradosu R. Images in clinical medicine. Eczema vaccinatum--a timely reminder. N Engl J Med. 2002;346(17):1287.
- Reed JL, Scott DE, Bray M. Eczema vaccinatum. Clin Infect Dis. 2012;54(6):832-840.
- Vellozzi C, Lane JM, Averhoff F, et al. Generalized vaccinia, progressive vaccinia, and eczema vaccinatum are rare following smallpox (vaccinia) vaccination: United States surveillance, 2003. Clin Infect Dis. 2005;41(5):689-697.
- Cono J, Casey C, Bell D. Smallpox vaccination and adverse reactions. Guidance for clinicians. MMWR Recomm Rep. 2003;52(RR-4):1–28.
- Herderson DA. Smallpox vaccination: a review, part II: adverse events, Clin Infect Dis. 2003;37:251-271.