Vaccinia ocular

Vaccinia Vaccinia immune globulin Consult the CDC.3 Treatment of severe reactions to vaccinia vaccination, including eczema vaccinatum, vaccinia necrosum, and ocular vaccinia. Available from the CDC.3... 

One of the most thorough surveys of adverse reactions associated with vaccinia vaccines was conducted in the United States and published by the CDC in 1968,89 and is summarized in Table 27-3. As a consequence of percutaneous inoculation, infectious vaccine virus is present in the local lesion. Consequently, inadvertent inoculation to other skin and mucous membrane sites (autoinoculation) or to other persons (secondary inoculation) is the most frequent complication of vaccinia intradermal vaccination.90 92 Ocular vaccinia is a particularly troublesome problem resulting from secondary inoculation (Figure 27-6). Erythematous or urticarial rashes may occur approximately 10 days after primary vaccination and, rarely, Stevens-Johnson syndrome occurs. Generalized vaccinia is characterized... 

Fig. 27-6. Ocular vaccinia following inadvertent autoinoculation with vaccine. This complication can cause corneal scarring and hence visual impairment. Ocular vaccinia should be treated aggressively with a topical antiviral drug under close ophthalmological supervision. Reprinted with permission from Fenner F, Henderson DA, Arlta I, Jezek Z, Ladnyi ID. Smallpox and Its Eradication. Geneva, Switzerland World Health Organization 1988 298. Photograph by C. H. Kempe.

Vaccinia-immune globulin (VIG) is of value in the treatment of progressive vaccinia, eczema vaccinatum,97 and perhaps ocular vaccinia (VIG is discussed below in the section titled Passive Immunoprophylaxis). Topical idoxuridine may benefit vaccinia keratitis.98 99... 

Acute epithelial herpes simplex keratitis (dendritic keratitis) fungal diseases of ocular structures vaccinia, varicella and most other viral diseases of the cornea and conjunctiva ocular tuberculosis hypersensitivity after uncomplicated removal of a superficial corneal foreign body mycobacterial eye infection acute, purulent, untreated eye infections that may be masked or enhanced by the presence of steroids. 

Hypersensitivity to any component of these products epithelial herpes simplex keratitis (dendritic keratitis) vaccinia varicella mycobacterial infections of the eye fungal diseases of the ocular structure use of steroid combinations after uncomplicated removal of a corneal foreign body. 

Contraindications Hypersensitivity to ciprofloxacin or other quinolones for ophthalmic administration vaccinia, varicella, epithelial herpes simplex, keratitis, mycobacterial infection, fungal disease of ocular structure, use after uncomplicated removal of a foreign body... 

Vaccinia Vaccinia immune globulin Treatment generalized, ocular, skin infections... 

Absolute hypersensitivity to the drug or any other component of the product. Active or suspected ocular or periocular infection (herpes simplex keratitis, vaccinia, varicella, mycobacterial disease or fungal infection), systemic fungal infections, advanced glaucoma or concurrent administration of live vaccines in patients receiving immunosuppressive doses. 

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