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Human monkeypox: confusion with chickenpox.

Z Jezek1, M Szczeniowski, K M Paluku

  • 1Communicable Diseases Division, World Health Organization, Geneva, Switzerland.

Acta Tropica
|December 1, 1988
PubMed
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Human monkeypox is often misdiagnosed as chickenpox due to similar symptoms like skin rash and fever. Differentiating monkeypox requires careful observation of lymph node enlargement and lesion development.

Area of Science:

  • Medical Virology
  • Epidemiology
  • Dermatology

Background:

  • Human monkeypox is a zoonotic disease endemic to Central and West Africa.
  • Accurate diagnosis is challenging due to sporadic occurrence and potential misdiagnosis with other eruptive diseases.
  • Increased surveillance in Zaire revealed a need to understand diagnostic errors.

Purpose of the Study:

  • To assess the extent and reasons for clinical diagnostic errors in human monkeypox cases.
  • To identify key differentiating clinical features between monkeypox and other eruptive diseases, particularly chickenpox.
  • To improve diagnostic accuracy in endemic areas.

Main Methods:

  • Laboratory testing of 977 patients with skin eruptions not clinically diagnosed as monkeypox in Zaire (1981-1986).

Related Experiment Videos

  • Analysis of clinical features in misdiagnosed monkeypox cases.
  • Comparison of diagnostic difficulties with chickenpox and other unspecified skin rashes.

    • Main Results:

    • 3.3% of suspected chickenpox cases were confirmed as monkeypox.
    • 7.3% of "atypical chickenpox" and 6.1% of unspecified skin rashes were monkeypox.
    • Misdiagnosis often stemmed from chickenpox-like features: pleomorphism (46%), indefinite distribution (49%), and centripetal lesions (17%).
    • Lymphadenopathy was present in 76% of misdiagnosed patients.

    Conclusions:

    • Clinical diagnostic errors are significant in differentiating human monkeypox from chickenpox.
    • Key indicators for monkeypox diagnosis include lymphadenopathy, pre-eruptive fever, and slower lesion maturation.
    • Improved clinical awareness and diagnostic criteria are crucial for accurate monkeypox identification.