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June 1957

Fatal Agammaglobulinemic Progressive Vaccinia: Report of a Case with a Classification of Human Cutaneous Vaccinia

Author Affiliations


From the Departments of Dermatology and Pediatrics, Children's Hospital, Denver.

AMA Arch Derm. 1957;75(6):837-844. doi:10.1001/archderm.1957.01550180051011

Ordinarily, when a person is intentionally infected with vaccinia virus, his recovery from that infection parallels his ability to produce appropriate, adequate, antivaccinal antibodies. If these cannot be manufactured, uninhibited vaccinia virus growth is likely to occur, and the outcome is almost invariably fatal. The failure to produce such immunizing antibodies may be due to (1) agammaglobulinemia or (2) a qualitative defect of the gamma globulin known as dysgammaglobulinemia. In the latter, treatment with hyperimmune vaccinia gamma globulin may be life saving,1 but despite therapy there is no recorded instance to date of recovery from agammaglobulinemic vaccinia.

Report of Case

Dec. 4, 1953: Negro girl born, weight 5 lb., 4 oz. (2.4 kg.). Delivery normal. Pregnancy uncomplicated.

June 7, 1954: Smallpox vaccination produced no reaction.

Aug. 18: Revaccinated.

Aug. 25: Primary take recorded, physical examination normal.

Aug. 28: Vesicular lesion appeared on face, simulating