Fatal Borealpox in an Immunosuppressed Patient Treated With Antivirals and Vaccinia Immunoglobulin—Alaska, 2023
Rattachement africain : us, Ouganda. Niveau de preuve : code pays fourni par la source.
Le résumé fourni par la source
BACKGROUND: Borealpox virus (BRPV, formerly known as Alaskapox virus) is a zoonotic member of the Orthopoxvirus genus first identified in a person in 2015. In the 6 patients with infection previously observed, BRPV involved mild and self-limiting illness. We report the first fatal BRPV infection in an immunosuppressed patient. METHODS: A man aged 69 years from Alaska's Kenai Peninsula was receiving anti-CD20 therapy for chronic lymphocytic leukemia. He presented to care for a tender, red papule in his right axilla with increasing induration and pain. The patient failed to respond to multiple prescribed antibiotic regimens and was hospitalized 65 days after symptom onset for progression of presumed infectious cellulitis. BRPV was eventually detected through orthopoxvirus real-time polymerase chain reaction testing of mucosal swabs. He received combination antiviral therapy, including 21 days of intravenous tecovirimat, intravenous vaccinia immunoglobulin, and oral brincidofovir. Serial serology was conducted on specimens obtained posttreatment initiation. FINDINGS: The patient's condition initially improved with plaque recession, reduced erythema, and epithelization around the axillary lesion beginning 1 week posttherapy. He later exhibited delayed wound healing, malnutrition, acute renal failure, and respiratory failure. He died 138 days after symptom onset. Serologic testing revealed no evidence the patient generated a humoral immune response. No secondary cases were detected. CONCLUSIONS: This report demonstrates that BRPV can cause overwhelming disseminated infection in certain immunocompromised patients. Based on the patient's initial response, early BRPV identification and antiviral therapies might have been beneficial. These therapies, in combination with optimized immune function, should be considered for patients at risk for manifestations of BRPV.
Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.
Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Fatal Borealpox in an Immunosuppressed Patient Treated With Antivirals and Vaccinia Immunoglobulin—Alaska, 2023
- Date Crossref
- 05/11/2024
- Éditeur
- Oxford University Press (OUP)
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
-
Centers for Disease Control and Prevention pays non établi dans la noticeOrganisme public
-
Alaska Department of Health and Social Services pays non établi dans la noticeOrganisme public
-
Epidemic Intelligence Service pays non établi dans la noticeOrganisme public
-
Providence Alaska Medical Center Department of Medicine pays non établi dans la noticeÉtablissement de santé
-
Inc. (United States) Karius pays non établi dans la noticeEntreprise
-
Centers for Disease Control and Prevention Ouganda (code pays fourni par la source)Organisme public
-
Section of Epidemiology pays non établi dans la noticeInstitution
-
Alaska State Public Health Laboratories pays non établi dans la noticeInstitution
-
Poxvirus and Rabies Branch pays non établi dans la noticeInstitution
-
Infectious Disease Pathology Branch pays non établi dans la noticeInstitution
Centers for Disease Control and Prevention, Alaska Department of Health and Social Services et Epidemic Intelligence Service, avec 7 autres affiliations. Pays d’affiliation : Ouganda.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.