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Report: A Pox Presenting Without Pox.

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A man with human immunodeficiency virus (HIV) experienced an unusual monkeypox rash presentation. This case highlights atypical symptoms during the 2022 monkeypox outbreak.

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Area of Science:

  • Infectious Diseases
  • Viral Infections
  • Dermatology

Background:

  • Human immunodeficiency virus (HIV) management and coinfections.
  • The 2022 global outbreak of nonvariola orthopoxvirus (monkeypox).
  • Travel-related infectious disease transmission.

Observation:

  • A patient with virally suppressed HIV presented with fever, fatigue, and myalgias.
  • An erythematous, morbilliform rash without pustules was observed.
  • Recent travel history to Mexico and Puerto Rico was noted.

Findings:

  • Diagnosis of nonvariola orthopoxvirus (monkeypox) infection.
  • The patient's rash presentation was atypical for monkeypox.
  • The case occurred within the context of the 2022 monkeypox outbreak.

Implications:

  • Understanding atypical monkeypox presentations is crucial for early diagnosis.
  • This case emphasizes the importance of considering monkeypox in febrile patients with rash, regardless of typical symptoms.
  • Highlights the need for awareness of orthopoxvirus in travelers returning from endemic or outbreak areas.