Smallpox

Case history

Two patients, a 16-year-old female and a 52-year-old obese male with a history of diabetes mellitus, present to the emergency department of a large hospital within 12 hours of each other. Both present with a history of feeling ill for approximately 2 days with fever, malaise, and prostration. Physical exam reveals papular lesions on the face and forearms. All lesions are at the same stage of development. Although unrelated, both patients recall being at the same shopping mall 2 weeks prior where there were news reports of a suspicious incident. The infectious diseases team is urgently contacted.