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Laboratory-acquired vaccinia infection
Clifford G Wlodaver1, Gregory J Palumbo, Joseph L Waner
1Department of Microbiology and Immunology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
Summary
Generalized vaccinia, a rare complication of vaccinia virus exposure, was diagnosed in an unvaccinated individual following a lab accident. Electron microscopy confirmed the poxvirus infection, highlighting its diagnostic utility.
Area of Science:
- Virology
- Infectious Diseases
Background:
- Vaccinia virus complications are known but infrequent.
- Increased use of vaccinia virus in research and potential bioterrorism threats necessitate awareness of post-vaccination complications.
- Clinical and laboratory diagnostic methods for vaccinia virus infections are crucial.
Observation:
- A case report of an unvaccinated subject experiencing generalized vaccinia after a laboratory accident.
- Clinical evaluation and laboratory support were utilized for differential diagnosis.
- The patient's history and workplace were assessed to identify the etiology.
Findings:
- Generalized vaccinia was diagnosed based on clinical presentation, history, and workplace evaluation.
- Electron microscopy (EM) confirmed the presence of poxvirus particles in infected cell cultures.
- The vaccinia virus replicated effectively in cell cultures, allowing for EM-based identification.
Implications:
- Healthcare providers should maintain a high index of suspicion for vaccinia virus exposure in patients with skin lesions.
- Direct examination of lesion material by electron microscopy offers a rapid diagnostic approach.
- Cell culture and EM can facilitate timely diagnosis of vaccinia virus infections, even without specific immune reagents.