Aggressive use of Vaccinia Immune Globulin (VIG) is the mainstay of treatment for Progressive
Vaccinia.
Managing Progressive Vaccinia
|
| VIG |
Massive doses of VIG are necessary to control
viremia. Up to 10 ml per kg of intramuscular VIG has been used. Plasma from recently vaccinated donors, irradiated blood, and platelet infusions has occasionally been administered. A few patients received exchange transfusions in an effort to supply immunologic factors as well as to counteract anemia and the metabolic defects resulting from organ
failure.
Caution: Graft-versus-host disease must be avoided. Viable lymphocytes, even from a single unit of blood, can cause GVHD in patients with profound CMI defects. |
Surgery
Followed
by VIG |
Surgical removal of massive lesions has been performed to reduce viral mass. In a few patients, this has been the turning point in treatment after which VIG administration resulted in eventual cure.
|
Antiviral Therapy |
There is no proven antiviral therapy.
Preliminary studies with cidofovir show some effect in vitro; studies in animals are pending. Immediate consultation with the CDC is recommended to determine if any experimental antiviral drugs are available.
|
Future Therapy
|
In the future, therapy might include immunologic
replacement, provided graft-versus-host disease can be
eliminated or minimized.
|
Bacterial, Fungal or Parasitic Superinfections
Patients with bacterial, fungal or parasitic superinfections should receive appropriate antimicrobial therapy.
Toxic or Septic Shock
Patients with toxic or septic shock should receive current intensive care and appropriate
toxic or septic shock therapy.
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