The Monkeypox (Mpox) virus (MPXV) is endemic in Africa, and cases outside West and Central Africa were previously considered rare. However, around May 2022, outbreaks of multiple cases were reported worldwide includin...The Monkeypox (Mpox) virus (MPXV) is endemic in Africa, and cases outside West and Central Africa were previously considered rare. However, around May 2022, outbreaks of multiple cases were reported worldwide including the USA thus presenting a new public health emergency. We present a case report of MPXV infection in a 49-year-old gay male with AIDS who was admitted for management of severe perianal cellulitis. Three days into hospitalization, he developed pustules over the genitals and scattered lesions over the face, trunk and extremities. PCR testing from a pustule was positive for MPXV. He was initiated on tecovirimat as well as antiretroviral therapy. There was a worsening of his rash over the first three days of therapy, followed by a gradual but complete resolution of all the skin lesions. The perianal and gluteal lesions were the most persistent and took more than two months to resolve. A primary contact source of infection was never identified. The differential diagnoses for cutaneous lesions of MPXV infection are also discussed.展开更多
BACKGROUND Monkeypox(MPX)is a zoonotic infection that is endemic in Western and Central Africa along the Congo River basin.It has a high case fatality rate especially in younger age groups.It belongs to the virus fami...BACKGROUND Monkeypox(MPX)is a zoonotic infection that is endemic in Western and Central Africa along the Congo River basin.It has a high case fatality rate especially in younger age groups.It belongs to the virus family orthopoxvirus like smallpox.It is transmitted from wild animals to humans but human to human transmission has been established.It is often a self-limited infection in endemic regions.Recently,attention has been given to MPX with the spread of infection to Europe and the United States of America(USA).There is currently sporadic infection of MPX in the USA especially amongst men who have sex with men(MSM).It is a serious life-threatening infection in human immunodeficiency virus/acquired immunodeficiency syndrome co-infected individuals especially those who are treatment naïve with severe immunosuppression.CASE SUMMARY We report a 38-year old man who presented with rectal pain,and anal,torso,and facial rash.Abdominal computed tomography scan showed a near obstructive rectal mass with peri-anal fistula.MPX was positive.He was started on tecovirimat(TPOXX)and HAART therapy.Additional treatment provided included vaccinia immunoglobulin following his clinical deterioration.CONCLUSION This case highlights a rare presentation of MPX with peri-anal fistula and near obstructive rectal mass,and the significance of MPX as a differential diagnosis in proctitis in MSM in addition to other sexually transmitted infection like gonorrhea and chlamydia.展开更多
文摘The Monkeypox (Mpox) virus (MPXV) is endemic in Africa, and cases outside West and Central Africa were previously considered rare. However, around May 2022, outbreaks of multiple cases were reported worldwide including the USA thus presenting a new public health emergency. We present a case report of MPXV infection in a 49-year-old gay male with AIDS who was admitted for management of severe perianal cellulitis. Three days into hospitalization, he developed pustules over the genitals and scattered lesions over the face, trunk and extremities. PCR testing from a pustule was positive for MPXV. He was initiated on tecovirimat as well as antiretroviral therapy. There was a worsening of his rash over the first three days of therapy, followed by a gradual but complete resolution of all the skin lesions. The perianal and gluteal lesions were the most persistent and took more than two months to resolve. A primary contact source of infection was never identified. The differential diagnoses for cutaneous lesions of MPXV infection are also discussed.
文摘BACKGROUND Monkeypox(MPX)is a zoonotic infection that is endemic in Western and Central Africa along the Congo River basin.It has a high case fatality rate especially in younger age groups.It belongs to the virus family orthopoxvirus like smallpox.It is transmitted from wild animals to humans but human to human transmission has been established.It is often a self-limited infection in endemic regions.Recently,attention has been given to MPX with the spread of infection to Europe and the United States of America(USA).There is currently sporadic infection of MPX in the USA especially amongst men who have sex with men(MSM).It is a serious life-threatening infection in human immunodeficiency virus/acquired immunodeficiency syndrome co-infected individuals especially those who are treatment naïve with severe immunosuppression.CASE SUMMARY We report a 38-year old man who presented with rectal pain,and anal,torso,and facial rash.Abdominal computed tomography scan showed a near obstructive rectal mass with peri-anal fistula.MPX was positive.He was started on tecovirimat(TPOXX)and HAART therapy.Additional treatment provided included vaccinia immunoglobulin following his clinical deterioration.CONCLUSION This case highlights a rare presentation of MPX with peri-anal fistula and near obstructive rectal mass,and the significance of MPX as a differential diagnosis in proctitis in MSM in addition to other sexually transmitted infection like gonorrhea and chlamydia.
