RSS Feeds
Progressive Vaccinia with Normal Antibodies
A Case Possibly Due to Deficient Cellular Immunity
- CORNELIUS J. O'CONNELL, M.D.;
- DAVID T. KARZON, M.D.;
- ALMEN L. BARRON, PH.D.;
- MARTIN E. PLAUT, M.D.; and
- VILAYAT M. ALI, M.D.
- Requests for reprints should be addressed to Cornelius O'Connell, M.D., Department of Medicine, State University of New York, Buffalo School of Medicine, 100 High Street, Buffalo 3, New York.
Excerpt
Of the several complications attending vaccination against smallpox, the rarest and most grave is the development of progressive vaccinia. In this disorder the primary vaccination site fails to undergo its usual evolution which normally leads to regression in the second week. On the contrary, it spreads, becoming deep and necrotic. Metastatic lesions appear at distant cutaneous and visceral sites, and most cases terminate fatally. Progressive vaccinia, thus defined, is synonymous with "vaccinia gangrenosa" and "vaccinia necrotica" and must be differentiated from the more common condition, generalized vaccinia (Kaposi's varicelliform eruption) in which widespread lesions occur but then proceed to evolve
Acknowledgment
The authors are indebted to Dr. Murray S. Howland for permission to report this case, to Dr. Robert H. Bussell for performance of the interferon tests and to Dr. Sidney Shulman for serum protein studies. The kindness of Drs. Ernest Witebsky and Evan Calkins in critically reviewing the manuscript is also acknowledged.
Summario in Interlingua
Un feminina de estate avantiate disveloppava vaccinia progressive con lesiones metastatic post le vaccination. Normal nivellos de globulina gamma esseva presente, e anticorpore de inhibition de hemagglutinina e etiam anticorpore neutralisante se disveloppava con alte titros. Nulle subjacente morbo esseva detegibile, e un test del capacitate del leucocytos del patiente de producer interferon non monstrava un manco in ille capacitate. Le patiente non disveloppava le expectate positive tardive reaction cutanee a antigeno de vaccinia; adenopathia non occurreva; e un paucitate de monocytos esseva notate in le sectiones histologic del lesion. Post que exogene hyperimmun globulina gamma non effectuava un responsa, therapia con immun leucocytos esseva essayate in duo occasiones. Isto succedeva in transferer un tardive responsa cutanee a vaccinia e resultava, in ambe occasiones, in un marcate melioration del lesiones. Le autores presenta le postulato que le occurrentia de vaccinia progressive in iste caso resultava ab le non-disveloppamento de immunitate "cellular" o tardive in despecto del presentia de un responsa normal del anticorpore circulante.
Article and Author Information
-
From the Departments of Medicine, Pediatrics, and Bacteriology and Immunology, School of Medicine, State University of New York at Buffalo, New York.
-
This study was supported in part by a Public Health Service Research Career Program Award (AI-K6-1136) from the National Institute of Allergy and Infectious Diseases, United States Public Health Service, Bethesda, Maryland.
-
- Received June 24, 1963.
- Accepted September 9, 1963.
