title: Ocular vaccinia following exposure to a smallpox vaccinee.
abstract: OBJECTIVE
  To describe the presentation and management of the first identified case of ocular vaccinia infection associated with the current smallpox vaccination program.
  
  
  METHODS
  Case report.
  
  
  METHODS
  Vaccinia virus was isolated by cell culture of a conjunctival swab. Direct staining with fluorescein isothiocyanate-labeled vaccinia antibody and polymerase chain reaction testing confirmed the diagnosis.
  
  
  RESULTS
  In February 2003, a 26-year-old woman developed right preseptal cellulitis and blepharoconjunctivitis following contact with a vaccinated member of the military. The preseptal cellulitis resolved with antibacterial therapy, and the conjunctival infection was treated successfully with a 14-day course of topical trifluridine and a single dose of intravenous vaccinia immune globulin.
  
  
  CONCLUSIONS
  To facilitate rapid diagnosis and appropriate treatment, clinicians must maintain a high index of suspicion for ocular smallpox vaccine-associated adverse reactions in vaccine recipients and their close contacts.
authors.affiliation: Ocular Inflammatory Disease Center, Jules Stein Eye Institute and Department of Ophthalmology, Los Angeles, California 90095-1688, USA. dpegues@mednet.ucla.edu
authors.forename: Gang
authors.initials: G
authors.lastname: Hu
authors.forename: Marcus J
authors.initials: MJ
authors.lastname: Wang
authors.forename: Marjorie J
authors.initials: MJ
authors.lastname: Miller
authors.forename: Gary N
authors.initials: GN
authors.lastname: Holland
authors.forename: David A
authors.initials: DA
authors.lastname: Bruckner
authors.forename: Rachel
authors.initials: R
authors.lastname: Civen
authors.forename: Lee A
authors.initials: LA
authors.lastname: Bornstein
authors.forename: Laurene
authors.initials: L
authors.lastname: Mascola
authors.forename: Michael A
authors.initials: MA
authors.lastname: Lovett
authors.forename: Bartly J
authors.initials: BJ
authors.lastname: Mondino
authors.forename: David A
authors.initials: DA
authors.lastname: Pegues
mesh_terms: D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use; D001762:Blepharitis / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D003228:Conjunctiva / Q000821:virology; D003236:Conjunctivitis, Viral / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D018562:Disease Transmission, Infectious; D005260:Female; D019084:Fluorescent Antibody Technique, Indirect; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D008889:Military Personnel; D016133:Polymerase Chain Reaction; D012900:Smallpox Vaccine / Q000009:adverse effects*; D014271:Trifluridine / Q000627:therapeutic use; D014611:Vaccination / Q000009:adverse effects; D014615:Vaccinia / Q000635:transmission*; D014616:Vaccinia virus / Q000302:isolation & purification
chemical_list: D000998:Antiviral Agents; D016756:Immunoglobulins, Intravenous; D012900:Smallpox Vaccine; D014271:Trifluridine