Vaccination against smallpox with a live attenuated virus has resulted in a variety of statistically minor but clinically unusual complications including reported cases of encephalitis, acute renal failure, glomerulonephritis, thrombocytopenic purpura, and vaccinial keratitis.1 The keratitis is considered a serious ocular complication2 in spite of reports which allude to its benignity when treated with a number of therapeutic agents including cortisone.3
Presented here is a single case of keratitis immediately associated with generalized vaccinia, thought to clinically represent vaccinial keratitis which was treated with 5-iodo-2′-deoxyuridine (IDU).*
Realizing that a single case might stand as apocryphal concerning the efficacy of treatment, we still feel that the unusual circumstances of the corneal disease and the course of the illness after IDU treatment are of significant interest.
Vaccinia is a laboratory virus evolved from cowpox or variola virus which is modified by animal passage through calves or rabbits and irreversibly
JACK MK, SORENSON RW. Vaccinial Keratitis Treated with IDU. Arch Ophthalmol. 1963;69(6):730–732. doi:10.1001/archopht.1963.00960040736009
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