Orf in sheep's clothing

The infection has six distinct clinical stages

When a man presented to hospital with an enlarging dark lesion on his left thumb, ED doctors bet the farm on a zoonotic origin.

Orf infection stages
The New England Journal of Medicine ©2021.

The 45-year-old reported that he had been in direct contact with sheep and handled meat on a farm three weeks earlier.

The lesion had initially manifested as a targetoid papule seven days later (see panel A)