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October 27, 1956


Author Affiliations

Durham, N. C.

From the Division of Dermatology and Syphilology and the Department of Medicine, Duke University School of Medicine. Dr. Smith is now at the University of Miami School of Medicine, Miami, Fla.

JAMA. 1956;162(9):887-888. doi:10.1001/jama.1956.72970260006010b

The danger of dissemination of bacterial infection by cortisone therapy is well known, and this can usually be managed by appropriate antibiotic therapy. The possibility of virus dissemination under similar circumstances has received less notice. There are no completely satisfactory virucidal agents for managing such a complication should it occur. The purpose of this report is to emphasize the danger of dissemination of virus infections in patients under cortisone therapy and to describe a fatal case of vaccinia in such a patient. The vaccinia infection occurred in a patient who had chronic lymphocytic leukemia and a low gamma globulin level and was on prolonged cortisone therapy.

Hill1 recently mentioned three deaths among children who contracted varicella while receiving cortisone for other reasons. Autopsies in these children revealed varicella lesions in all organs. Thygeson2 and Ormsby and others3 point out the danger of extension of herpes simplex in

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