Sarma Deba P, Cox Meredith, Walter Paige, Crisler William, Huerter Christopher
Department of Pathology, Creighton University Medical Center, Omaha, NE 68131, USA.
Case Rep Med. 2010;2010:524021. doi: 10.1155/2010/524021. Epub 2010 May 31.
Introduction. Ecthyma contagiosum is a zoonotic disease caused by the parapoxvirus that causes "sore mouth" in sheep and goats and orf in human. Case Presentation. A 61-year-old sheep farmer presented with a painful non-pruritic lesion on the left hand that had been present for approximately 5 weeks. Physical examination demonstrated a 1 cm pearly, umbilicated papule with raised borders. A biopsy showed an asymmetrical nodule with parakeratotic crust and acanthosis with thin epidermal strands extending deeply in the underlying dermis. Marked edema, capillary proliferation and extensive lymphocytic infiltration was also present. One red intranuclear inclusion was identified in an epidermal keratinocyte. A diagnosis of human orf (ecthyma contagiosum) was made. Conclusion. Infected sheep and freshly vaccinated sheep or goats are the reservoir for human infection. After an incubation period of 3-7 days, parapoxvirus infections produce 1-3 painful lesions measuring 1-2 cm in diameter. The natural history of the disease is complete resolution and no treatment is indicated. Prevention of echthyma contagiosum in ruminants through vaccination is thought to be the best way to control infection.
引言。传染性脓疱病是一种由副痘病毒引起的人畜共患病，该病毒可导致绵羊和山羊患“口疮”，人类患羊痘疮。病例报告。一名61岁的养羊农民左手出现一个疼痛性非瘙痒性皮损，已存在约5周。体格检查发现一个1厘米大小的珍珠样、脐凹状丘疹，边界隆起。活检显示为一个不对称结节，伴有角化不全性痂皮和棘层肥厚，表皮细束深深延伸至下方真皮层。还存在明显水肿、毛细血管增生和广泛淋巴细胞浸润。在一个表皮角质形成细胞中发现一个红色核内包涵体。诊断为人羊痘疮（传染性脓疱病）。结论。感染的绵羊以及刚接种疫苗的绵羊或山羊是人类感染的传染源。经过3至7天的潜伏期后，副痘病毒感染会产生1至3个直径为1至2厘米的疼痛性皮损。该病的自然病程是完全消退，无需治疗。通过疫苗接种预防反刍动物的传染性脓疱病被认为是控制感染的最佳方法。
