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Extensive orf infection in a toddler with associated id reaction
Authors:Ellen S. Haddock AB  MBA  Carol E. Cheng MD  John S. Bradley MD  Christopher H. Hsu MD  PhD   MPH  Hui Zhao MD  Whitni B. Davidson MPH  Victoria R. Barrio MD
Affiliation:1. School of Medicine, University of California, San Diego, San Diego, CA, USA;2. Division of Dermatology, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA;3. Division of Infectious Diseases, Rady Children's Hospital‐San Diego, San Diego, CA, USA;4. Division of Infectious Diseases, School of Medicine, University of California, San Diego, San Diego, CA, USA;5. Department of Pediatrics, School of Medicine, University of California, San Diego, San Diego, CA, USA;6. Poxvirus and Rabies Branch, Division of High‐Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA;7. Epidemic Intelligence Service, Atlanta, GA, USA;8. Department of Dermatology, Rady Children's Hospital‐San Diego, San Diego, CA, USA;9. Department of Dermatology, School of Medicine, University of California, San Diego, San Diego, CA, USA
Abstract:Orf is a zoonotic parapoxvirus typically transmitted to humans by a bite from goats or sheep. We present an unusual case of multiple orf lesions on the fingers of a 13‐month‐old child who was bitten by a goat and subsequently developed progressive swelling, blistering, and necrotic papulonodules of the hand followed by an additional diffuse, pruritic, papular rash. A primary diagnosis of orf infection was confirmed using real‐time polymerase chain reaction, and the diffuse eruption was clinically consistent with an id reaction. Extensive necrosis and papular id reaction associated with orf rarely have been described.
Keywords:child  contagious pustular dermatitis  ecthyma contagiosum  goat  infection  orf  parapoxvirus  virus
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