Vaccinia or cowpox resulting from auto-inoculation in a vaccinated person is rather infrequent and usually tends to be benign even in the generalized form. The same disease superimposed on infantile eczema, although rare, is far more serious and usually proves fatal when the face is involved. It may result from direct contact with the virus and is easily confused at first with variola and impetigo. Cases have been reported by Hoffman, Finkelstein, Kiezling, Kobrak, Danzigea, Jerome, Meyer, Swoboda, Eichoff and Hegeler.
The fatal case reported here is of interest from the standpoint of differential diagnosis and should emphasize the importance of surgical asepsis in vaccination against smallpox in children. It afforded an opportunity for bacteriologic investigation of tissues following clinical evidence of encephalitis.
REPORT OF A CASE
R. V., a white boy, aged 5 months, was admitted to the hospital because of fever, restlessness and facial eczema which had become