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Cowpox infection of the nose

W C Lee1, G Manjaly, D W Skinner

  • 1Department of Otolaryngology, Eye, Ear and Throat Hospital, Shrewsbury, UK.

Insights

A rare case of cowpox virus infection caused necrotizing cellulitis of a patient's nose. Diagnosis involved electron microscopy and chorio-allantoic membrane lesions, confirming a novel presentation and dog-to-human transmission.

Area of Science:

  • Veterinary Medicine
  • Infectious Diseases
  • Dermatology

Background:

  • Cowpox virus (CPXV) is a zoonotic pathogen.
  • CPXV infections typically manifest as skin lesions.

Observation:

  • A patient presented with necrotizing cellulitis affecting the nasal tip and vestibule.
  • The clinical presentation mimicked other severe facial infections.

Findings:

  • Diagnosis was confirmed by identifying poxvirus particles via electron microscopy of nasal biopsy tissue.
  • Characteristic lesions on the chorio-allantoic membrane of embryonated eggs further supported the diagnosis.
  • The identified strain was consistent with CPXV.

Implications:

  • This case represents the first reported instance of cowpox infection involving the external nose.
  • The findings suggest a potential route of transmission from domestic animals, specifically dogs, to humans.
  • Highlights the importance of considering zoonotic viral infections in atypical facial cellulitis cases.

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