Last data update: Dec 02, 2024. (Total: 48272 publications since 2009)
Records 1-1 (of 1 Records) |
Query Trace: Newell KG[original query] |
---|
Fatal borealpox in an immunosuppressed patient treated with antivirals and vaccinia immunoglobulin - Alaska, 2023
Rogers JH , Westley B , Mego T , Newell KG , Laurance J , Smith L , Parker J , Park SY , Venkatasubrahmanyam S , Noll N , Bercovici S , Rao AK , McCollum AM , Davidson W , Carson WC , Townsend MB , Doty JB , Hutson C , Li Y , Wilkins K , Deng J , Gigante CM , Satheshkumar PS , Tuttle A , Villalba JA , Bhatnagar J , Reagan-Steiner S , Castrodale LJ , McLaughlin JB . Clin Infect Dis 2024 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 six patients with infection previously observed BRPV involved mild, 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 postsymptom 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 one-week post-therapy. He later exhibited delayed wound healing, malnutrition, acute renal failure, and respiratory failure. He died 138 days postsymptom onset. Serologic testing revealed no evidence the patient generated a humoral immune response. No secondary cases were detected. CONCLUSION: 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. |
- Page last reviewed:Feb 1, 2024
- Page last updated:Dec 02, 2024
- Content source:
- Powered by CDC PHGKB Infrastructure