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Staphylococcal infection is most often due to
S. aureus or related species. This results in a vesiculo-pustular lesion at the site of vaccination, often spreading peripherally in circumferential fashion, with clearing behind the advancing border. Bacterial lymphangitis and regional lymphadenitis may occur, but most often the lesions are solely superficial infections.
Streptococcal infection may result in lesions similar to staphylococcal impetigo, but more commonly one sees a piled up eschar, heaping at the vaccination site. Lymphangitis occurs commonly as does edematous painful regional lymphadenitis.
Streptococci and staphylococci may occasionally co-infect the vaccination site.
Enteric and anaerobic infections may present with purulence or with extensive necrosis at the vaccination site. Necrotic fasciitis has also been encountered in some cases.
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