Zoonotic orf virus infection during the mpox global outbreak

A 35-year-old otherwise healthy male shepherd was presented with a 5-day history of solitary cutaneous lesion on the forefinger of his left hand with slight pain. Systemic symptoms, including fever, lymphadenopathy and malaise, are all denied. He reported scab-like and ulcerative cutaneous lesions around the lip and mouth of the sheep he raised (Figure  1A). Physical examination showed solitary swelling and erythematous cutaneous lesion with a central ulcer involving the forefinger of the left hand (Figure  1B). No positive evidence has been shown in further laboratory evaluation, including whole blood cell count and infectious diseases, including anti-HIV and anti-syphilis detection. A skin biopsy was performed, and the obtained specimen was sent for histopathological evaluation displayed hyperkeratosis, acanthosis, edema and spongiform degeneration in the epidermis; edema existed in the papillary layer of the dermis with dense inflammatory cells infiltration. The skin swab sample was also obtained for further pathogen identification using metagenomic next-generation sequencing (BGI, China). The presence of the orf virus at the higher relative abundance was confirmed. All clinical, histopathological and pathogenic evidence were supported the diagnosis of orf virus infection, a zoonotic infection event.
Source: QJM - Category: Internal Medicine Source Type: research