title: 'Orf on the ear', in a patient with Guillain-Barré Syndrome.
abstract: We report a case of orf on an ear in a patient admitted to hospital following the onset of Guillain-Barré syndrome. While the underlying causes of Guillain-Barré syndrome are not completely understood, immune stimulation appears to play a key role in pathogenesis. Any association between orf infection and Guillain-Barré syndrome has not been documented. A 22-year-old male sheep farmer, who was previously fit and well, presented to his local hospital with a 2-day history of distal upper and lower limb paraesthesia and weakness. He was transferred to a tertiary hospital where the diagnosis of Guillain-Barré syndrome was confirmed. History revealed that he had experienced a mild respiratory illness 3 weeks prior to presentation and an inflamed nodular lesion over his left ear, which had appeared 2 weeks prior to admission. Differential diagnoses of orf, atypical mycobacterial infection, subcutaneous mycosis and a squamous cell carcinoma were considered. Histopathology from a biopsy of the lesion was consistent with orf, which was confirmed by polymerase chain reaction testing. This case is of interest for two reasons: orf has not been described in association with Guillain-Barré syndrome, and orf on the ear is uncommon.
authors.affiliation: Department of Dermatology, Royal Perth Hospital, Western Australia, Australia. drdaramsingh@gmail.com
authors.forename: Daram
authors.initials: D
authors.lastname: Singh
authors.forename: Sujith Prasad
authors.initials: SP
authors.lastname: Kumarasinghe
mesh_terms: D000328:Adult; D004427:Ear Diseases / Q000150:complications* / Q000473:pathology / Q000821:virology*; D004474:Ecthyma, Contagious / Q000150:complications* / Q000473:pathology / Q000821:virology*; D020275:Guillain-Barre Syndrome / Q000150:complications*; D006801:Humans; D008297:Male