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Open AccessCase Report

Two Distinct Clinical Courses of Human Cowpox, Germany, 2015

1
Institute of Medical Microbiology and Epidemiology of Infectious Diseases, University Hospital, 04103 Leipzig, Germany
2
Central Diagnostic Laboratory Division, Bundeswehr Institute of Microbiology, 80937 Munich, Germany
3
Institute of Animal Hygiene and Veterinary Public Health, University of Leipzig, 04103 Leipzig, Germany
4
Ear, Nose and Throat Clinic, University Hospital, 04103 Leipzig, Germany
5
Department of Viruses and Intracellular Agents, Bundeswehr Institute of Microbiology, 80937 Munich, Germany
*
Author to whom correspondence should be addressed.
Viruses 2017, 9(12), 375; https://doi.org/10.3390/v9120375
Received: 23 November 2017 / Revised: 4 December 2017 / Accepted: 6 December 2017 / Published: 7 December 2017
(This article belongs to the Special Issue Smallpox and Emerging Zoonotic Orthopoxviruses: What Is Coming Next?)
Here we present two cases of human infection with cowpox virus with distinct clinical courses. A series of clinical photographs documents lesion progression over time. In the first case—an unvaccinated young veterinary assistant—a pustule was treated locally with cortisone. The lesion turned into a large ulcer accompanied by severe lymphadenitis. Based on her close contact to a sick stray cat, infection with cowpox virus was assumed and confirmed by virus isolation, PCR, and serology. The clinical course took up to eleven months until healing of the wound was complete. Transmission of cowpox virus from the cat was likely because a skin swab was PCR-positive and the cat had a high titer of anti-orthopoxvirus antibodies. In contrast, a rather mild clinical course of cowpox was confirmed in a 49-year-old male farmer vaccinated against smallpox. Only a small eschar developed, and wound closure was complete after 6 weeks. View Full-Text
Keywords: cowpox virus; Orthopoxvirus; skin lesion; zoonotic transmission cowpox virus; Orthopoxvirus; skin lesion; zoonotic transmission
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Eder, I.; Vollmar, P.; Pfeffer, M.; Naether, P.; Rodloff, A.C.; Meyer, H. Two Distinct Clinical Courses of Human Cowpox, Germany, 2015. Viruses 2017, 9, 375.

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