FRIDAY, July 2 (HealthDay News) -- Following sexual contact with her military serviceman boyfriend, who had been recently vaccinated for smallpox, a woman in Washington state contracted vaccinia virus infection in her vagina, according to a case report published in the July 2 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.
John S. Pauk, M.D., of the Polyclinic in Seattle, and colleagues reported on the case, which began on February 26 when the woman, in her 20s, went to a clinic with vaginal pain. The examining physician noted vaginal swelling and a circular lesion with central ulceration on the right labia majora. Despite the woman's mention of her boyfriend's recent vaccination, the physician initially cultured for sexually transmitted diseases and prescribed valacyclovir, azithromycin, cefazolin, and ceftriaxone.
On March 1, the woman visited another clinic and a second examining physician observed new lesions on both labia minora and within the vaginal vault and one swollen lymph node. The physician swabbed for vaccinia virus, but the transport medium was improper and it was not tested at the lab. The physician also referred the woman to an infectious disease specialist, who examined her on March 2, prescribed Vicodin for pain, counseled the woman about infection control, and took another swab, which tested positive for orthopoxvirus and for nonvariola orthopoxvirus. Several days later, the specialist reported signs of healing of the vaginal lesions.
"Clinicians should suspect infections with vaccinia virus in patients with vesiculopapular rashes and known exposures to recent smallpox vaccinees, including sexual contact," the authors write.