Orf virus confirmed in persistent hand lesions after farm animal contact

A case report in Tidsskrift for Den norske legeforening describes a woman in her 40s referred for two exuding, swollen, blistering lesions on her right hand. Approximately 14 days earlier, she had sustained a burn and a superficial abrasion on separate fingers. The following day, she visited a farm and petted a horse, cow, goat and sheep. Both wounds became increasingly swollen, warm and tender during the week before admission.

She was afebrile and hemodynamically stable, with a C-reactive protein concentration of 14 mg/L and otherwise unremarkable laboratory findings. Following orthopedic and surgical assessments, discussion with an infectious disease specialist identified the clinical appearance and exposure history as consistent with orf. Testing detected orf virus DNA in wound fluid, while bacterial culture was negative. During her two-day admission, the lesions enlarged and mild redness extended up the arm. Suspected secondary bacterial skin infection prompted oral phenoxymethylpenicillin, 1 g four times daily for 10 days.

At telephone follow-up four weeks after discharge, she reported that the blisters had gradually dried and detached, followed by substantial improvement. Orf is a parapoxvirus zoonosis primarily affecting sheep and goats; disrupted skin likely facilitated infection in this case. The report highlights animal exposure history when evaluating persistent hand lesions. Orf generally resolves spontaneously; antibiotics address suspected bacterial complications, not the virus. This single case cannot establish antibiotic benefit.