Orf progressiva: giant progressive and destructive infections in the immunocompromised
| Autor: | Caroline Opene, Maxwell A Fung, Marc Silverstein |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Adult
Male medicine.medical_specialty Orf virus viruses medicine.medical_treatment Eosinophilic inclusions Imiquimod Dermatology Antiviral Agents chemistry.chemical_compound Immunocompromised Host Dermis Ciprofloxacin medicine Ecthyma Contagious Humans Pseudomonas Infections Debridement business.industry Standard treatment General Medicine Kidney Transplantation Anti-Bacterial Agents Transplantation medicine.anatomical_structure chemistry Superinfection Valacyclovir Pseudomonas aeruginosa Drug Therapy Combination business Cidofovir medicine.drug |
| Zdroj: | Dermatology online journal. 27(1) |
| ISSN: | 1087-2108 |
| Popis: | Orf virus causes a self-limited infection in humans that resolves without scarring within 6-12 weeks. However, lesions in the immunocompromised can be progressive and disfiguring. The lesions frequently recur after treatment. To our knowledge, there are eleven published cases of these infections. We propose the name orf progressiva to call attention to this progressive, treatment-resistant entity. We present a 43-year-old male ranch owner with a history of renal transplantation who contracted an orf infection from his lamb. The infection recurred despite attempts at debridement, but achieved near complete resolution after treatment with imiquimod and valacyclovir. The histologic findings of orf progressiva are identical to the early stages of classic orf infection and are characterized by epithelial hyperplasia, intracytoplasmic eosinophilic inclusions, and an edematous, vascular dermis. There is no standard treatment for orf progressiva. Surgical excision has frequently resulted in rapid reoccurrence. Topical therapies such as imiquimod and cidofovir cream in combination with excision have been successful in some cases. Acyclovir or valacyclovir with imiquimod has been reported to be effective. Two patients achieved cure with imiquimod alone. We summarize these cases to prompt recognition of orf progressiva as a distinct clinical entity that requires treatment. |
| Databáze: | OpenAIRE |
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