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Genital orf.

Krishna Thazhatheyil1, Vasiliki Kourouni2, Alan Evans3

  • 1Dermatology, Ninewells Hospital and Medical School Department of Dermatology, Dundee, UK krishnat1787@gmail.com.

BMJ Case Reports
|January 27, 2025
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Summary
This summary is machine-generated.

A sheep farmer developed extensive genital lesions due to orf virus infection, a zoonotic disease. Prompt diagnosis through occupational history and PCR testing is crucial for managing this condition.

Keywords:
DermatologicalDermatologyGeneral practice / family medicine

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Area of Science:

  • Dermatology
  • Infectious Diseases
  • Zoonotic Infections

Background:

  • Orf virus (OV) is a parapoxvirus that causes contagious ecthyma, primarily in sheep and goats.
  • Human orf virus infection is rare and typically occurs through direct contact with infected animals or contaminated materials.
  • Genital orf virus infection is an uncommon presentation, often misdiagnosed due to its varied clinical appearance.

Purpose of the Study:

  • To report a case of genital orf virus infection in a sheep farmer.
  • To highlight the importance of occupational history in diagnosing zoonotic infections.
  • To discuss the clinical presentation, diagnostic methods, and management of genital orf virus.

Main Methods:

  • Clinical case presentation of a man with extensive genital lesions.
  • Physical examination and dermatological assessment.
  • Laboratory investigations including skin biopsy, bacterial cultures, and viral PCR.
  • Review of patient's occupational history (sheep shearing).

Main Results:

  • The patient presented with erythematous, maculopapular lesions evolving into vesicles, pustules, and cellulitis in the groin and genital areas.
  • Skin biopsy revealed epidermal changes consistent with viral infection, excluding other diagnoses like atypical mycobacterial infection.
  • Viral PCR confirmed the presence of orf virus.
  • Secondary bacterial infection was present, necessitating antibiotic treatment.

Conclusions:

  • Genital orf virus infection should be considered in patients with suggestive genital lesions, especially those with occupational exposure to livestock.
  • Detailed occupational and contact history is critical for accurate diagnosis.
  • While orf virus infection treatment is typically conservative, secondary bacterial infections require appropriate management.