Preemptive Tecovirimat Use in an Active Duty Service Member Who Presented With Acute Myeloid Leukemia After Smallpox Vaccination

Clin Infect Dis. 2019 Nov 27;69(12):2205-2207. doi: 10.1093/cid/ciz286.

Abstract

Smallpox vaccine is contraindicated in immunosuppression due to increased risk for adverse reactions (eg, progressive vaccinia). We describe the first-ever use of tecovirimat as a preemptive vaccinia virus treatment strategy during induction chemotherapy in an active duty service member who presented with acute leukemia and inadvertent autoinoculation after smallpox vaccination.

Keywords: ST-246; leukemia; smallpox vaccine; tecovirimat; vaccinia.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Antiviral Agents / administration & dosage*
  • Benzamides / administration & dosage*
  • Humans
  • Immunoglobulins, Intravenous / therapeutic use
  • Isoindoles / administration & dosage*
  • Leukemia, Myeloid, Acute / diagnosis*
  • Leukemia, Myeloid, Acute / etiology
  • Leukemia, Myeloid, Acute / therapy
  • Male
  • Military Personnel*
  • Premedication
  • Smallpox / prevention & control*
  • Smallpox Vaccine / administration & dosage
  • Smallpox Vaccine / adverse effects*
  • Smallpox Vaccine / immunology*
  • Symptom Assessment
  • Treatment Outcome
  • Vaccination* / adverse effects
  • Vaccination* / methods
  • Vaccinia virus / drug effects*
  • Vaccinia virus / immunology

Substances

  • Antiviral Agents
  • Benzamides
  • Immunoglobulins, Intravenous
  • Isoindoles
  • Smallpox Vaccine
  • tecovirimat