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February 1962

Vaccinia Gangrenosa in Chronic Lymphatic Leukemia: Report of a Case with Recovery Following the Use of Vaccinia Immune Globulin

Author Affiliations


From the Medical Service, Veterans Administration Hospital, West Haven, Conn., and the Department of Medicine, Yale University School of Medicine, New Haven, Conn.; Formerly Resident in Medicine, Veterans Administration Hospital, West Haven, Conn., presently Instructor in Medicine, the Johns Hopkins University School of Medicine, Baltimore (Dr. Fekety); formerly Assistant Resident in Medicine, presently Clinical Associate, National Institutes of Arthritis and Metabolic Diseases, National Institutes of Health, Bethesda, Md. (Dr. Malawista); formerly Assistant Resident in Medicine, presently Assistant Resident in Medicine, Parkland Memorial Hospital, Dallas, Texas (Dr. Young).

Arch Intern Med. 1962;109(2):205-208. doi:10.1001/archinte.1962.03620140077012

Since a successful smallpox vaccination is in a sense an iatrogenic disease, it is particularly unfortunate that patients with chronic lymphatic leukemia may develop a progressive necrotizing vaccinial infection (vaccinia gangrenosa) following this procedure. In the past, this complication has invariably been fatal.3 This is the report of an adult with chronic lymphatic leukemia who recovered from vaccinia gangrenosa with the aid of vaccinia immune globulin.

Report of Case  A 66 year old white retired postal worker was admitted to the hospital on June 22, 1959, because of weakness of 3 days' duration. He had been found to have chronic lymphatic leukemia in 1956 and had been treated with radiation and chlorambucil. One month before admission his hematocrit was 37%. He felt well until a few days before admission, taking chlorambucil, 2 mg/day. In preparation for a trip abroad, he was vaccinated by his private physician on June 17.

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