Sunday, April 24, 2005

Case for diagnosis (Alberta, Canada)

Day #1 this guy helped deliver a breech calf by c-section which was so traumatic that the calf was still-born and then the following day he helped butcher a cow. On Day #3 he noted swelling of his left index finger and by
Day #4 it blew up to look like these pictures. The more I read about orf the more I feel that this is likely the case. The risk factors are there and the time of year and setting is classic. Anyway, what do the viewers think?

(The break in the skin/expelled fluid in the pictures is my doing. There
were no vesicles or absesses and the tissue was tough and non-fluctuent.)



  1. It certainly has the appearance of Orf but I usually think of Orf being aquired from infected sheep!I would certainly consider bovine papular stomatitis which can give orf like lesions in humans and is self limiting but also consider blistering distal dactylitis which is a streptococcal infection especially if there is any lymphangitis.Swabs for viruses and bacteria.Histopathology of orf is characteristic.
    Best wishes

  2. I agree with Dr. McColl that orf is a disease contracted from sheep or goats. The only case that I have seen presented with vesicles with umbilicated centers. Bovine papular stomatitis is a possibility, as is a necrotizing cellulitis caused by Staph aureus or Group A streptococcus.

  3. No body can differentiate

  4. No body can differentiate between milkers node and orf unless we use electron microscope.The present case could be milker nodule or orf contracted from a sheep or goat days before handling the present case(cattle)


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