Manifestations of Monkeypox Described in Case Series

MONDAY, July 25, 2022 (HealthDay News) — Monkeypox manifests with dermatologic and systemic clinical infections, according to a report published online July 21 in the New England Journal of Medicine.

John P. Thornhill, M.D., Ph.D., from Queen Mary University of London, and colleagues describe the presentation, clinical course, and outcomes of 528 monkeypox infections diagnosed between April 27 and June 24, 2022, at 43 sites in 16 countries.

The researchers found that 98 percent of the people with infection were gay or bisexual men (median age, 38 years), 41 percent had HIV, and 75 percent were White. In 95 percent of the persons with infection, transmission was suspected to have occurred through sexual activity. Among the cases included, 95 percent presented with a rash; 64 percent had <10 lesions and 73 and 41 percent had anogenital and mucosal lesions, respectively. Fever, lethargy, myalgia, and headache were common systemic features preceding the rash (62, 41, 31, and 27 percent, respectively); lymphadenopathy was reported in 56 percent. In 29 percent of the 377 persons tested, concomitant sexually transmitted infections were reported. The median incubation period was seven days among the 23 persons with a clear exposure history. In 29 of 32 persons in whom seminal fluid was analyzed, monkeypox virus DNA was detected. Five percent of the persons were given antiviral treatment; 13 percent were hospitalized, mainly for pain management, soft-tissue superinfection, pharyngitis limiting oral intake, eye lesions, acute kidney injury, myocarditis, and infection-control purposes. There were no deaths reported.

“Without widely available treatment or prophylaxis, rapid case identification is vital to containment,” the authors write.