Department of Dermatology and Allergology, Ludwig-Maximilan University, Munich, Germany.
Acta Derm Venereol. 2012 Mar;92(2):126-31. doi: 10.2340/00015555-1227.
Cowpox virus infection of humans is an uncommon, potentially fatal, skin disease. It is largely confined to Europe, but is not found in Eire, or in the USA, Australasia, or the Middle or Far East. Patients having contact with infected cows, cats, or small rodents sporadically contract the disease from these animals. We report here clinical aspects of 8 patients from the Munich area who had purchased infected pet rats from a local supplier. Pet rats are a novel potential source of local outbreaks. The morphologically distinctive skin lesions are mostly restricted to the patients' necks, reflecting the infected animals' contact pattern. Individual lesions vaguely resemble orf or Milker's nodule, but show marked surrounding erythema, firm induration and local adenopathy. Older lesions develop eschar, leaving slow-healing, deep ulcerative defects after eschar separation. Severe flu-like illness may be present in the acute phase. Smallpox-vaccinated patients tend to develop less severe reactions and heal more quickly. The differential diagnosis may include other localized orthopoxvirus infections, herpes simplex, bacterial infection, anthrax, foreign body granuloma, and primary tuberculosis. Dermatologists should be aware of the diagnostic and therapeutic algorithms for handling this disease.
牛痘病毒感染人类是一种罕见的、潜在致命的皮肤病。它主要局限于欧洲，但在爱尔兰、美国、澳大拉西亚、中东或远东都没有发现。与受感染的奶牛、猫或小型啮齿动物接触的患者偶尔会从这些动物身上感染这种疾病。我们在这里报告了来自慕尼黑地区的 8 名患者的临床情况，他们从当地供应商那里购买了受感染的宠物鼠。宠物鼠是局部暴发的新的潜在来源。形态独特的皮肤损伤主要局限于患者的颈部，反映了受感染动物的接触模式。单个病变隐约类似于羊痘或挤奶工结节，但表现出明显的周围红斑、硬结和局部淋巴结病。陈旧病变形成干痂，在干痂分离后留下愈合缓慢的深部溃疡性缺损。在急性期可能会出现类似流感的严重疾病。接种过天花疫苗的患者往往会出现较轻的反应，并且愈合得更快。鉴别诊断可能包括其他局部正痘病毒感染、单纯疱疹、细菌感染、炭疽、异物肉芽肿和原发性肺结核。皮肤科医生应该了解处理这种疾病的诊断和治疗方案。
