Treatment for the complications associated with vaccinia virus is supportive.
VIG may be helpful in selected patients, such as those with generalized vaccinia and eczema vaccinatum or those at high risk for developing complications following vaccination with vaccinia. VIG is less successful when used for treatment of progressive vaccinia and CNS complications.
VIG was developed from pooled sera collected from vaccinated patients in the 1960s and is available from the Centers for Disease Control and Prevention (CDC) in Atlanta, GA.
VIG is contraindicated in patients with allergies to VIG or sensitivity to human pooled serum.
Cidofovir and adefovir are being investigated to evaluate the clinical effect and outcomes as a secondary treatment of vaccinia-related complications that do not respond to VIG treatment. An oral form of this drug is currently under development.
Surgery is usually unhelpful in the treatment of complications, although debridement of nonviable tissue in cases of vaccinia necrosum may be considered. Obtaining a biopsy of suspected lesions can aid in the diagnosis.
Consultation with a dermatologist may be helpful when the diagnosis of a skin lesion is in doubt.
Suspected cases of vaccinia-related complications should be treated in consultation with an expert in infectious diseases and poxvirus virology.
Selective consultation for specific adverse events is indicated (eg, an ophthalmologist for eye complications or a neurologist for nervous system complications).
No special dietary precautions apply to patients with vaccinia-related complications.
No specific activity limitations apply to patients with vaccinia-related complications.
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