Generalized vaccinia

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
Founder, WikiMD Wellnesspedia &
W8MD medical weight loss NYC and sleep center NYC

Generalized vaccinia
Generalized vaccinia rash
Synonyms	N/A
Pronounce	N/A
Specialty	N/A
Symptoms	Rash, fever, malaise
Complications	Secondary bacterial infection, encephalitis
Onset	4 to 10 days after vaccination
Duration	1 to 2 weeks
Types	N/A
Causes	Vaccinia virus
Risks	Eczema, immunodeficiency
Diagnosis	Clinical diagnosis, PCR
Differential diagnosis	Eczema vaccinatum, smallpox, chickenpox
Prevention	Avoidance of smallpox vaccine in at-risk individuals
Treatment	Supportive care, antiviral drugs
Medication	N/A
Prognosis	Generally good with treatment
Frequency	Rare
Deaths	N/A

Generalized vaccinia is a rare complication of the smallpox vaccine, characterized by a widespread vesicular rash. It occurs when the vaccinia virus, used in the vaccine, spreads beyond the site of inoculation to other parts of the body. This condition is generally self-limiting and resolves without specific treatment, but it can be severe in individuals with compromised immune systems.

Pathophysiology

Generalized vaccinia results from the hematogenous spread of the vaccinia virus following vaccination. The virus can disseminate through the bloodstream, leading to the development of vesicular lesions on the skin. These lesions are similar in appearance to those at the vaccination site but occur at distant locations on the body.

Clinical Presentation

Patients with generalized vaccinia typically present with a fever and a rash that appears 6 to 9 days after vaccination. The rash consists of vesicular lesions that can cover large areas of the body. These lesions are usually benign and resolve within 10 to 14 days. In immunocompromised individuals, however, the condition can be more severe and may require medical intervention.

Diagnosis

Diagnosis of generalized vaccinia is primarily clinical, based on the characteristic appearance of the rash and the history of recent smallpox vaccination. Laboratory tests, such as polymerase chain reaction (PCR) and viral cultures, can confirm the presence of the vaccinia virus.

Treatment

In most cases, generalized vaccinia does not require specific treatment and resolves spontaneously. Supportive care, including antipyretics and topical treatments for the rash, may be provided to alleviate symptoms. In severe cases, particularly in immunocompromised patients, antiviral medications such as cidofovir may be considered.

Prevention

Preventing generalized vaccinia involves careful screening of individuals before smallpox vaccination. Those with a history of eczema, atopic dermatitis, or immunosuppression should be evaluated carefully, as they are at higher risk for complications. Proper vaccination techniques and post-vaccination care are also essential to minimize the risk of virus spread.

See also

• Smallpox vaccine
• Vaccinia virus
• Complications of smallpox vaccination