A 25-year-old milkman presented with a painful facial ulcer occupying the left malar region with underlying edema extending to the eye obstructing his vision (Fig. 1a). Ulcer base was soft and tender. Patient had fever and cervical lymphadenopathy. Multiple whitish nodules were seen over the dorsal aspect of both hands with edema (Fig. 1b). Similar nodules were present on udder of buffalo. A diagnosis of buffalo pox was established. Prophylactic antibiotics with local wound care led to complete healing of ulcer in 3 weeks (Fig. 1c).
Buffalopox is a viral zoonotic disease caused by the buffalopox virus affecting domestic buffalos (Bubalus bubalis). The buffalopox virus belongs to the genus Orthopoxvirus a member of family Poxviridae. The virus is transferred to humans from buffalo while milking. Human-to-human transmission is possible. Outbreaks of buffalopox have been reported in India and worldwide. The treatment of human buffalopox infection involves wound care, and antibiotics to prevent secondary infection which can lead to ulcers as occurred in this case. The use of hand gloves while milking can prevent transmission. The clinicians must be aware of such condition as facial involvement is rare in buffalopox and it is a public health hazard.
