Fatal Agammaglobulinemic Progressive Vaccinia

A case of vaccinia necrosum (or progressive vaccinia), with severe hypogammaglobulinaemia, treated with n-methyl isatin beta-thiosemicarbazone (33T57)

“…However, the lesions in the lungs, with the proliferation of bronchiolar epithelium, are unusual and have not been described in this condition, though Lewis and Johnson (1957) described squamous metaplasia of the bronchioles in their case of progressive vaccinia; Kozinn, Sigel, and Gorrie (1955), whose patient had been treated with A.C.T.H. and cortisone, found coagulation necrosis in several organs, which was not present in this case.…”

Necropsy findings in a case of progressive vaccinia

“…A focal necrotizing pneumonitis with little inflammation has been previously noted (Hall, Cunliffe, (1953) Not seen Keidan et al (1953) Skin Cytoplasm Eosinophilic Kozinn et al (1955) Bronchi and kidney Cytoplasm Eosinophilic Barbero et al (1955) Periostium Cytoplasm Eosinophilic Somers (1957) Skin, tongue, and 'Intracellular' Eosinophilic oesophagus S6dallian et al (1957) Skin Not stated Not stated Lewis and Johnson (1957) Skin Cytoplasm Eosinophilic Galloway and MacBean (1958) Not seen Medansky et al (1960) Not mentioned Kozlowska and Sztymela (1962) Not mentioned Flewett and Ker (1963) Skin Cytoplasm and nuclei Eosinophilic White (1963) Not mentioned O'Connell et al (1964) Skin Cytoplasm Eosinophilic Van Rooyen et al (1967) Not seen Dixon (1970) Not seen Kozinn, Sigel, and Gorrie, 1955;Flewett and Ker, 1963;Dixon, 1970). In other instances purulent inflammation was also seen (Bigler and Slotkowski, 1951;Lewis and Johnson, 1957;Somers, 1957) but the presence of bacteria in the lesions in two of these cases suggests that this was due to secondary infection.…”

“…In other instances purulent inflammation was also seen (Bigler and Slotkowski, 1951;Lewis and Johnson, 1957;Somers, 1957) but the presence of bacteria in the lesions in two of these cases suggests that this was due to secondary infection. Proliferative changes of the bronchial or bronchiolar epithelium have also been noted previously (Bigler and Slotkowski, 1951;Lewis and Johnson, 1957;Flewett and Ker, 1963;Dixon, 1970). This change, although not specific, may be useful in the histological diagnosis of the lesions.…”