Orf Infection with Multiple Lesions in the Burn Area

Abstract

Orf, a viral zoonotic disease, is caused by the orf virus, an epitheliotropic DNA virus from the parapoxvirus group. 1 It is caused by direct or indirect contact of decontaminated skin with infected animals. The incubation period is 3-15 days, and it usually progresses with one or more nodular lesions that appear on the dorsal surface of the fingers. The disease usually heals spontaneously after a course of 4-8 weeks. [2][3][4][5] Here, we present two pediatric patients with orf, unlike the classical localization, occurred in the burn area and progressed with multiple lesions. CASE REPORTS CASE 1A two-year-old male patient had a second degree burn due to hot water on the right side of his scalp, face and neck 10 days ago. In his dermatological examination, numerous red papules, plaques and vegetative masses were found on an erythematous and intensely edematous surface in the area extending from the right frontal region of the scalp to the occipital region (Figure 1A). Herpes simplex virus (HSV), Varicella-Zoster virus (VZV) polymerase chain reaction (PCR) and skin punch biopsy were taken from the lesions of the patient whose family was engaged in ovine breeding. Since eczema herpeticum was in the differential diagnosis and some of the lesions had a secondary infected appearance, acyclovir and ampcillin sulbactam treatments were started. As the HSV and VZV PCR results were negative, acyclovir treatment was discontinued, but ampicillin sulbactam treatment was continued for one week. Histopathological examination of the case re-