Progressive vaccinia is diagnosed clinically by the typical appearance of the vaccination site. This disease is suspected in patients with underlying CMI defects.
Progressive Vaccinia Differential
|
Condition
|
Notes
|
| Severe bacterial infection |
Differentiate by:
| • |
Vigorous inflammatory response |
| • |
Lack of history compatible with immune defect |
|
Severe cases of smallpox |
Smallpox might be confused with progressive vaccinia in an individual who has been vaccinated and exposed
|
Severe chickenpox |
Differentiate by:
| • |
Lack of a primary vaccination site |
| • |
If vaccinated, the character of the lesions (superficial vesicles, in varying stages, with typical distribution) |
|
Disseminated herpes simplex infections |
Differentiate by:
| • |
Lack of a primary vaccination site |
| • |
If vaccinated, the character of the lesions (superficial vesicles, in varying stages, with typical distribution) |
|
Testing
Virologic and immunologic laboratory
testing can help confirm the diagnosis of progressive vaccinia and should be done after consultation with:
| • |
State or local health authorities |
| • |
Infectious disease or immunology experts with
experience in complications of vaccination, and/or |
| • |
CDC |
Treatment should be based on clinical presentation and findings, however, rapid viral diagnostic tests can help determine the potential etiologic agent that can be confirmed by more definitive, yet less rapid tests (e.g. viral culture).
|
