Human Cowpox Infection Workup

  • Author: Nikki A Levin, MD, PhD; Chief Editor: Dirk M Elston, MD   more...
 
Updated: Jul 22, 2011
 

Laboratory Studies

  • Electron microscopy of vesicle fluid or scab extracts is the most rapid and useful technique to aid in diagnosis. Orthopoxviruses, including cowpox, have characteristic "mulberry" and "capsule" forms that allow them to be differentiated from parapoxviruses and herpes viruses. Electron microscopy does not distinguish between cowpox, smallpox, vaccinia, and molluscum viruses, so clinical information is critical.
  • Virus may be grown from lesional skin in cell culture and then studied by electron microscopy. Growth on chick chorioallantoic membrane produces characteristic hemorrhagic pocks.
  • Polymerase chain reaction may be performed on biopsy material or cell culture extracts to amplify the cowpox A36R, thymidine kinase, or hemagglutinin gene and identify it by sequencing or restriction fragment length polymorphism analysis.[21]
  • Serologic tests to detect antibodies to cowpox virus are not routinely available in hospital laboratories but may be performed in research laboratories. Previous vaccination with vaccinia may cause false-positive results, but these can be eliminated by the use of specific immunoglobulin M tests.
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Procedures

Skin biopsy for routine histology, electron microscopy, culture, or molecular detection methods may be performed.

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Histologic Findings

Using routine light microscopy, characteristic cytoplasmic inclusions have been observed in biopsies from feline cowpox but not in human material. Immunohistochemistry detects cowpox antigens in feline cases. Using electron microscopy, biopsy material may reveal viral particles.

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Contributor Information and Disclosures
Author

Nikki A Levin, MD, PhD  Associate Professor of Medicine, Division of Dermatology, University of Massachusetts Medical School

Nikki A Levin, MD, PhD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, Phi Beta Kappa, and Sigma Xi

Disclosure: Nothing to disclose.

Specialty Editor Board

James Fulton Jr, MD, PhD  Center for Cosmetic Dermatology; Consultant, Vivant Pharmaceuticals, LLC

James Fulton Jr, MD, PhD is a member of the following medical societies: American Academy of Cosmetic Surgery, American Academy of Dermatology, American Society for Laser Medicine and Surgery, Dermatology Foundation, International Society of Cosmetic and Laser Surgeons, and Skin Cancer Foundation

Disclosure: Vivant Pharmaceuticals Grant/research funds Consulting

Richard P Vinson, MD  Assistant Clinical Professor, Department of Dermatology, Texas Tech University Health Sciences Center, Paul L Foster School of Medicine; Consulting Staff, Mountain View Dermatology, PA

Richard P Vinson, MD is a member of the following medical societies: American Academy of Dermatology, Association of Military Dermatologists, Texas Dermatological Society, and Texas Medical Association

Disclosure: Nothing to disclose.

Jeffrey Meffert, MD  Assistant Clinical Professor of Dermatology, University of Texas School of Medicine at San Antonio

Jeffrey Meffert, MD is a member of the following medical societies: American Academy of Dermatology, American Medical Association, Association of Military Dermatologists, and Texas Dermatological Society

Disclosure: Nothing to disclose.

Catherine M Quirk, MD  Clinical Assistant Professor, Department of Dermatology, University of Pennsylvania

Catherine M Quirk, MD is a member of the following medical societies: Alpha Omega Alpha and American Academy of Dermatology

Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD  Director, Ackerman Academy of Dermatopathology, New York

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

References

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A 16-year-old boy with generalized cowpox. Courtesy of Dr. Reinhard Hoepfl, Innsbruck, Austria.
 
 
 
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