Related Experiment Video
Updated: Sep 19, 2025
Subcutaneous Infection of Methicillin Resistant Staphylococcus Aureus MRSA
Published on: February 9, 2011
A Rare Case of Orf Virus Precipitating Methicillin-Resistant Staphylococcus Aureus Bacteremia Superinfection Leading
Alexander Price1, Cónan Marren1, Stephen Mulligan1
1Department of Orthopaedics, University Hospital Galway, Galway, Ireland.
Introduction:
Orf disease, or Ecthyma contagiosum, is a zoonotic skin infection caused by the orf virus. The orf virus belongs to the family parapoxvirus and is commonly seen in sheep, goats, and deer. Transmission to humans is most commonly caused by direct contact with infected animals or fomites. Septic arthritis is a serious orthopaedic condition that requires prompt identification and early medical treatment. Septic arthritis is often precipitated by bacteremia, which allows for hematogenous spread of the bacterial load to the affected joint. Without prompt effective treatment, septic arthritis can lead to significant long-term sequelae and disability.
Case Report:
This case report presents a rare occurrence of methicillin-resistant Staphylococcus aureus septic arthritis of a native hip joint in a 56-year-old Caucasian male, precipitated by Orf virus and subsequent bacteremia. The patient presented with lower back and left-sided groin pain that was progressively worsening, which he first noticed 3 weeks prior. He was a full-time sheep farmer and had been diagnosed with Orf virus on his hand 6 weeks before his current presentation. In addition, he had psoriasis and was taking a single biological immunosuppressive agent, although he did not have any active psoriatic lesions at this time. After a thorough clinical, biochemical, and radiographical assessment, a diagnosis of the left hip septic arthritis was made. He was promptly treated with surgical irrigation and debridement, and targeted intravenous antibiotic therapy. He responded well to the multidisciplinary approach to his care, had a dramatic improvement in his symptoms, and regained his hip range of motion.
Conclusion:
Immunocompromised patients need to be thoroughly assessed when presenting with joint pain. Zoonotic infections, especially around farm workers, can precipitate certain viral illnesses, in this case Orf virus, which can predispose patients to bacterial superinfection and subsequent septic arthritis. Prompt clinical, biochemical and radiographical assessment are essential to making an accurate diagnosis to allow for early surgical irrigation and debridement in patients affected by septic arthritis.
Insights
Orf virus, a zoonotic infection, can lead to severe septic arthritis in immunocompromised individuals. Early diagnosis and treatment, including surgical intervention and antibiotics, are crucial for recovery and preventing long-term disability.
Area of Science:
- Infectious Diseases
- Orthopedics
- Dermatology
Background:
- Orf disease (Ecthyma contagiosum) is a zoonotic skin infection caused by the orf virus (a parapoxvirus), common in sheep and goats.
- Transmission to humans typically occurs through direct contact with infected animals or contaminated fomites.
- Septic arthritis is a critical orthopedic condition requiring prompt diagnosis and treatment to prevent joint damage and disability.
Observation:
- This case report details a rare instance of methicillin-resistant Staphylococcus aureus (MRSA) septic arthritis in a native hip joint.
- The patient, a sheep farmer with psoriasis on immunosuppressive therapy, developed hip arthritis following an Orf virus infection on his hand.
- Symptoms included progressive left groin and lower back pain, leading to a diagnosis of septic arthritis.
Findings:
- A 56-year-old male sheep farmer presented with hip pain, later diagnosed as septic arthritis.
- The condition was precipitated by a prior Orf virus infection, leading to bacteremia and subsequent joint infection with MRSA.
- Prompt treatment involving surgical irrigation, debridement, and targeted intravenous antibiotics resulted in significant symptom improvement and restored hip function.
Implications:
- Immunocompromised individuals, particularly farm workers exposed to zoonotic infections like Orf virus, require careful evaluation for joint pain.
- Zoonotic viral infections can predispose individuals to secondary bacterial superinfections, such as septic arthritis.
- Timely clinical, biochemical, and radiographic assessment is vital for diagnosing septic arthritis and enabling early surgical and medical management.
Related Concept Videos
01:26Healthcare Associated Infections I: Iatrogenic, Exogenic and Endogenic
HAIs significantly increase the cost of health care. Extended stays in healthcare institutions, increased disability, increased costs of medications, including specialized antibiotics, and prolonged recovery times add to the patient's expenses and the healthcare institution and funding bodies.
01:25Endocarditis I: Introduction
01:25Endocarditis II: Clinical Features of Infective Endocarditis
01:26Factors Affecting the Risk of Infection
The integrity and count of the white blood cells help the body resist pathogens and fight infection. When impaired, it reduces the body's resistance to pathogens. The acidic pH levels of the gastrointestinal, genitourinary tracts, and skin...
01:28Acute Pyelonephritis II: Diagnostic Studies and Management
01:20Infection
The chain begins with pathogens: bacteria, viruses, fungi, prions, or parasites such as protozoa helminths. These can be present on the skin as transient or resident flora, or they can be acquired from the environment. Identifying and treating the type of infection and...