Clinicopathological Features of Orf Virus Infection in the Human: A Rare Case Report of Extensive Skin Infections and Meta‐Analysis

The Orf virus is responsible for causing contagious ecthyma in sheep and goats. Humans are primarily infected with Orf virus result in zoonotic skin diseases. We reported a rare case of orf virus infection affecting the face and thoracodorsal regions and performed pathological examination and metagenomic pathogen detection technology(MethPath^TM) test on the patient. A meta-analysis of the reported cases was also presented. All cases of human infection with orf virus were searched in PubMed and web of science databases. The pathology revealed eosinophilic inclusion bodies visible in the epidermal cells, and the demonstrated orf virus infection by MetaPath™. We identified 99 articles reporting 159 cases of human orf virus infection. The average (±SD) age of all patients was 34.96 ± 16.82 years. Male gender was predominant; hand infections were the most frequent. 81.3% of the patients were infected by contact with sheep. The observed recovery time averaged 42.7 days, with a median of 40 days. The most typical histopathological finding is characterized by the presence of eosinophilic inclusions within vacuolated epidermal cells. When facial nodular lesions are present, obtaining a detailed medical history is essential to aid in considering orf virus infection in the differential diagnosis.