Orbital cowpox
A 28-year-old woman in the UK developed an eye infection because of a rare virus, cowpox which she got from her pet cat. The woman reported to the emergency with complaints of redness, discharge and irritation in her eyes with a history of 5 days. Doctors prescribed her with a number of different antibiotics and antiviral drugs for treating a common eye infection. But, nothing helped alleviate her symptoms. What’s more, the symptoms only got worse with time.
Further examination showed that the patient had developed orbital cellulitis, an infection of the fat and soft tissues that hold the eye ball in its socket. It presents with extremely uncomfortable and painful symptoms. While it is not contagious, anyone can develop the condition. The doctors were concerned that she may actually lose her vision.
Dr. Miles Kiernan, an ophthalmologist at Royal Free Hospital in London, who treated the patient said: “Our worry was that the infection would damage her sight permanently, or likely spread past the orbit [eye socket].”
The patient’s history further revealed that two weeks earlier, her cat had developed similar lesions on its paws and head.
This led the doctors to believing that she may have acquired the infection from her pet cat. To confirm, doctors tested samples from both the cat’s lesions and woman’s eye. Both were positive for orthopoxvirus. Orthopoxvirus belongs to a family of poxviruses, including smallpox virus, monkeypox virus and cowpox virus. Further genetic sequencing confirmed the diagnosis of cowpox.
The viral infection is much milder than the highly contagious smallpox disease. Cowpox is a rare disease. Today, cows are no longer the carrier of the virus and the major reservoir is rodents. Woodland rodents are the natural hosts of the virus that pass it on to domestic cats. Cases in humans are quite rare and often because of domestic cat scratches and bites, as in this case.
Doctors suspected that the 28-year-old most likely caught the infection when she petted her cat and touched or rubbed her eye. Treatment included a prolonged course of tecovirimat and surgery for removal of dead tissue from around the eye. 6 months later the patient had 20/20 visual acuity in her right eye. Althoug with minor drooping of her upper eyelid and some trouble with eye movement.
References
Orbital Cowpox https://www.nejm.org/doi/full/10.1056/NEJMicm2033620
