Monkeypox
What?
Monkeypox virus belongs to the family Poxviridae, subfamily Chordopoxvirinae, and genus orthopoxvirus
Viral zoonotic disease that is caused by monkeypox virus
When to Suspect?
Characteristic Rash + risk factors for infection
How?
• Sexual activity
• Via cutaneous inoculation
• Fomites
• Live in a home with someone with Mpox
• Respiratory secretions
Monkeypox affects both children and adults
Typically has three phases:
• Incubation: Mean incubation period is 13 days
• Prodrome: High temperature, headache, fatigue, and often, lymphadenopathy - cervical and maxillary regions
• Eruptive stage:
- 14 to 28 days
- Skin lesions appear in a centrifugal distribution and progress through several stages: macules, papules, vesicles, and finally, pustules
- Umbilification
- Rash: 1 to 2 days before and 3 to 4 days after the onset of the systemic symptoms
- Continues for two to three weeks
Clinical Presentation:
• 6 to 36% of patients have reported rectal pain, rectal bleeding, or other symptoms of proctitis
• 10 to 21% of patients have had pharyngitis, epiglottitis, or ulcerative tonsillitis
• Painful lymphadenopathy, particularly in the cervical or inguinal region
• Mpox-related encephalitis, encephalomyelitis, myocarditis, and pneumonia
• 23% of patients with confirmed mpox had ocular manifestations
• Pruritus and myalgia
• Conjunctivitis
• Blepharitis
• Severe keratitis
• Photophobia
• Decreased visual acuity
Skin: The lesions develop crusts that desquamate → hypopigmentation → hyperpigmentation
• Occurs on palms and soles
• Oral ulcers and conjunctival damage
• Skin lesions: asynchronous
• Genital, anal, and perianal areas can be involved
DDX: Varicella, Herpes simplex virus, Other sexually transmitted infections, Impetigo, Molluscum contagiosum, Smallpox, Vaccinia virus, Other pox viruses
Viral Testing:
• Polymerase chain reaction (PCR) testing for orthopoxvirus DNA
• Serologic testing for monkeypox virus antiorthopoxvirus IgM antibody
Complications:
• Cutaneous bacterial infections
• Bronchopneumonia
• Respiratory distress
Treatment:
• Tecovirimat
• Brincidofovir
#Monkeypox #MPOX #Diagnosis #Management #Dermatology
