[Cowpox virus infection in a child]. / Infection à cowpox virus chez l'enfant.

UNLABELLED: Although human cowpox virus infection is rare nowadays, an animal reservoir of this virus still exists. The general course of cowpox virus infections is usually benign but the diagnosis is difficult and often late. CASE REPORT: An 11-year-old boy, owner of two cats, presented with an infected sacral wound lesion associated with fever and lymph nodes. The wound became necrotic and other cutaneous and mucous membrane lesions developed secondarily. Blood tests did not show hyperleukocytosis or a systemic inflammatory response. Concurrently one of the cats was examined by a veterinary because of multifocal cutaneous lesions. Evocative skin biopsy specimens from the animal and, secondarily from the patient, allowed the identification of orthopoxvirus. Evolution was slowly favourable under symptomatic treatment. CONCLUSION: Poxviruses are responsible for many animal and human diseases, the most famous of them being smallpox which today is considered eradicated. Vaccination against smallpox is no longer performed since 1977. Whether the arrest of vaccinations against smallpox may induce the apparition of other poxviruses infections or alter their clinical expression is an open question.

[A case of cowpox]. / Et tilfelle av kukopper.

A 37-year-old woman was admitted to the dermatology department at a regional hospital with a severe ulceration at the medial angle of the right eye. Virus culture yielded orthopoxvirus-like particles, later identified as cowpox virus. The clinical picture and virological diagnosis of cowpox are discussed. Emphasis is placed on the need for awareness among health personnel that such infections may well be encountered in an increasingly unvaccinated population. Guidelines for clinicians and for virology laboratories are given. Cats as a zoonoic source is discussed.

[Localized cowpox/cat pox virus infection. Aspects of epidemiology, diagnosis and therapy]. / Lokalisierte Infektion mit dem Kuhpocken-/Katzenpockenvirus. Aktuelles zur Epidemiologie, Diagnostik und Therapie.

Only few human cowpox/catpox infections have been reported until now. The diagnosis of bland localized infections may be missed, if this disease is not well known. However, early diagnosis of localized cowpox/catpox infections is important, since at least immunocompromised patients are at risk of potential lethal generalization similar to generalized variola vera. Using a typical case report, the characteristics of the disease, as well as the current aspects of epidemiology, diagnosis and therapy are summarized. The characteristic finding of intracytoplasmatic inclusion bodies by light microscopy can be demonstrated in a human biopsy-specimen for the first time and greatly facilitated the diagnosis.

Human cowpox 1969-93: a review based on 54 cases.

This survey of the clinical and epidemiological features of human cowpox, a rare but relatively severe zoonotic infection, is based on 54 cases, many unpublished, which we have studied since 1969. Patients present with painful, haemorrhagic pustules or black eschars, usually on the hand or face, accompanied by oedema, erythema, lymphadenopathy, and systemic involvement. Severe, occasionally fatal, cases occur in eczematous and immunosuppressed individuals, although cowpox has not yet been reported in anyone infected with the human immunodeficiency virus. Variations in the clinical features are described, and the differential clinical diagnosis of cowpox, parapox, herpes virus, and anthrax infections is discussed. The role of the laboratory in diagnosis is described, and the value of electron microscopy in providing rapid confirmation is emphasized. Care in taking a detailed history will assist in the initial clinical diagnosis, and a history of contact with domestic cats, particularly during July-October, is important. The possible influence of smallpox vaccination on the incidence and severity is discussed and discounted.