![]() Infertility (obstructive azoospermia) in males.Generally, it occurs when malnutrition and/or an opportunistic infection are present. Blindness is a rare occurrence and results from corneal scarring following keratitis or corneal ulcerations.Scarring may occur all over the body but is most profuse on the face, which has the highest concentration of sebaceous glands. Pockmarks and scarring are the most common sequelae.They are a consequence of virus-mediated necrosis and destruction of sebaceous glands. The crusts slough off around 14 days after rash onset. Lesions typically exhibit the same stage of development in any one area of the body at any given time.Ĭrusting and scab formation typically begins by the ninth day of exanthema. Within another 1 to 2 days, the vesicles often umbilicate and evolve to pustules that are round, tense, firm to the touch, and deep-seated within the dermis. Lesions develop uniformly throughout the disease and progress from macules to papules to vesicles over the course of 4 to 5 days. Lesions usually appear first on the oropharynx, followed by the face and extremities, and then spread to the trunk, palms, and soles in a centrifugal pattern of distribution. Eruptive StageĪs the fever subsides, rash lesions begin to develop. In pale-skinned patients, an erythematous rash, or rarely, a petechial rash, may be visible. The first symptoms of the prodrome begin after the incubation period and include: During this time, the infected person does not have symptoms, is not contagious, and may feel fine. Infection with variola virus begins with an incubation period usually lasting between 10 to 14 days (range 7 to 19 days). Ordinary smallpox was the most common form, accounting for over 85% of all cases during the smallpox era. ![]() During the smallpox era, the case-fatality rate differed for the different clinical forms, but it was approximately 30% overall in unvaccinated individuals. There are four main clinical forms of smallpox, each with different characteristics. ![]()
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