Progressive Vaccinia: Diagnosis


Progressive vaccinia is diagnosed clinically by the typical appearance of the vaccination site. This disease is suspected in patients with underlying CMI defects. Progressive Vaccinia Differential

	Condition	Notes

	Severe bacterial infection	Differentiate by:
		•	Vigorous inflammatory response
		•	Lack of history compatible with immune defect

	Severe cases of smallpox	Smallpox might be confused with progressive vaccinia in an individual who has been vaccinated and exposed

	Severe chickenpox	Differentiate by:
		•	Lack of a primary vaccination site
		•	If vaccinated, the character of the lesions (superficial vesicles, in varying stages, with typical distribution)

	Disseminated herpes simplex infections	Differentiate by:
		•	Lack of a primary vaccination site
		•	If vaccinated, the character of the lesions (superficial vesicles, in varying stages, with typical distribution)
Testing Virologic and immunologic laboratory testing is mandatory and should be accomplished after consultation with:

•	CDC or
•	Infectious disease or immunology experts with experience in complications of vaccination

Rapid viral diagnostic tests can determine the exact etiologic agent, confirmed by more definitive testing later.