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Poxviruses at a Glance
  • Poxviruses are the largest animal viruses; they can cause disease of varying severity in humans.
  • Smallpox is the only poxvirus for which humans are the sole reservoir, which allowed its eradication.
  • The smallpox vaccine virus, vaccinia, has its own adverse effects.
  • Monkeypox is a zoonotic infection endemic in Africa, but it has recently appeared in the Western Hemisphere.
  • Milker's nodule and orf mainly cause localized cutaneous infections.
  • Molluscum contagiosum is generally a benign cutaneous disease most frequently seen in children and immunocompromised individuals.
  • Histopathologic features of poxviral cutaneous lesions include the presence of intracytoplasmic eosinophilic inclusion bodies.

Poxviruses are double-stranded DNA viruses that replicate in the cytoplasm of host cells (Table 195-1). These “brick-shaped” viruses constitute the largest known animal viruses and can be seen with light microscopy.1 The poxviruses that cause significant disease in humans are reviewed here. Their effects on the host range from systemic disease to localized infection to epithelial cell proliferation alone.

Table 195-1 Poxviruses with Humans as Hosts

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