Contents

SynopsisCodesLook ForDiagnostic PearlsDifferential Diagnosis & PitfallsBest TestsManagement PearlsTherapyReferences

View all Images (8)

Potentially life-threatening emergency
Eczema vaccinatum vaccinia in Adult
Other Resources UpToDate PubMed
Potentially life-threatening emergency

Eczema vaccinatum vaccinia in Adult

Contributors: Art Papier MD, Vince Fulginiti MD
Other Resources UpToDate PubMed

Synopsis

Individuals with atopic dermatitis or eczema (active or healed) are at great risk from self-implantation of vaccinia virus from a vaccinia (smallpox) vaccination site onto eczematous skin, which can result in severe illness. Transfer of vaccinia virus can also occur from contact with a smallpox vaccinee whose vaccination lesion is in the florid stages.

The affected skin of atopic dermatitis patients, whether currently disrupted or healed, permits the viral implantation. Once the virus is implanted (and it may be implanted at multiple sites), it spreads from cell to cell, producing extensive lesions dependent only on the extent of the abnormal skin. An underlying T-cell immunologic defect is suspected in some patients with atopic eczema on the basis of their propensity to develop cutaneous viral and fungal infections and a decreased sensitivity to contact dermatitis, which is T-cell mediated.

Untreated patients become quite ill and experience systemic symptoms. Bacteremia and septicemia may result from local contamination or frank infection of the site at which time the patient will experience fever, chills, obtundation, and even coma. If unrecognized and untreated, the patient will manifest severe systemic symptoms resembling septic shock, and death ensues.

Codes

ICD10CM:
T88.1XXA – Other complications following immunization, not elsewhere classified, initial encounter

SNOMEDCT:
238368001 – Eczema vaccinatum

Look For

Subscription Required

Diagnostic Pearls

Subscription Required

Differential Diagnosis & Pitfalls

To perform a comparison, select diagnoses from the classic differential

Subscription Required

Best Tests

Subscription Required

Management Pearls

Subscription Required

Therapy

Subscription Required

References

Subscription Required

Last Updated:07/15/2018
Copyright © 2024 VisualDx®. All rights reserved.
Potentially life-threatening emergency
Eczema vaccinatum vaccinia in Adult
A medical illustration showing key findings of Eczema vaccinatum vaccinia : Fever, Patient appears ill, Umbilicated vesicles
Clinical image of Eczema vaccinatum vaccinia - imageId=169206. Click to open in gallery.  caption: 'A close-up of a cluster of umbilicated and crusted pustules, each with an erythematous halo.'
A close-up of a cluster of umbilicated and crusted pustules, each with an erythematous halo.
Copyright © 2024 VisualDx®. All rights reserved.