Research Letter |

Clinicopathological Findings in Persistent Corneal Cowpox Infection

Sybille Graef, MD1; Andreas Kurth, PhD2; Claudia Auw-Haedrich, MD3; Niklas Plange, MD5; Winfried V. Kern, MD4; Andreas Nitsche, PhD2; Thomas Reinhard, MD3
[+] Author Affiliations
1University Eye Hospital Tuebingen, Tuebingen, Germany
2German Consultant Laboratory for Poxviruses, Centre for Biological Security, Robert Koch Institute, Berlin, Germany
3University Eye Hospital Freiburg, Freiburg im Breisgau, Germany
4Centre for Infectious Diseases and Travel Medicine, Department of Medicine, University Hospital Freiburg, Freiburg im Breisgau, Germany
5Department of Ophthalmology, RWTH Aachen University, Aachen, Germany
JAMA Ophthalmol. 2013;131(8):1089-1091. doi:10.1001/jamaophthalmol.2013.264.
Text Size: A A A
Published online


Cowpox viruses (CPXVs) belong to the genus Orthopoxvirus.1 Increasingly, CPXV infections have been reported in domestic cats, rats, and exotic zoo animals, with humans potentially being infected through direct contact with these animals.1 Typically, a CPXV infection becomes apparent through the development of small skin lesions. Healing comes with scar formation and can take several weeks. Complications and severe courses have been reported in immunocompromised individuals.2

Figures in this Article

Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours

First Page Preview

View Large
First page PDF preview


Place holder to copy figure label and caption
Figure 1.
Preoperative and Postoperative Findings

A, Preoperative status of the right eye 18 months after primary infection with cowpox virus. B, Fluorescein staining shows widespread corneal erosion and step formation at the corneal margin (arrow). C, Postoperative finding 1 day after limbokeratoplasty. Arrows indicate the limbal part.

Graphic Jump Location
Place holder to copy figure label and caption
Figure 2.
Histological Analysis

A, Histological overview showing local bacterial infiltrations (arrow) (hematoxylin-eosin, original magnification ×100). B, The keratocytes seem to be swollen with granular cytoplasmic material (arrow) (hematoxylin-eosin, original magnification ×400). C, Immature virions (arrows) are located in the cytoplasm of keratocytes. Co indicates collagen fibers (scale bar = 500 nm). D, Mature virions (arrows) are enclosed by collagen fibers (Co) (scale bar = 500 nm).

Graphic Jump Location




Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Comment


Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Topics