Paraphimosis as a complication of monkeypox infection

Area of Science:

• Infectious Diseases
• Dermatology
• Urology

Background:

• Pre-exposure prophylaxis (PrEP) is used for HIV prevention.
• Unprotected sexual contact can increase STI risk.
• Monkeypox virus (MPXV) can cause mucocutaneous lesions.

Observation:

• A 38-year-old uncircumcised male on PrEP presented with painful penile lesions after unprotected sex.
• He subsequently developed painless, itchy pustules on his arms and back.
• Severe penile swelling caused paraphimosis, preventing foreskin retraction.

Findings:

• Standard STI tests (Chlamydia, HSV, Gonorrhea, Syphilis) were negative.
• Polymerase chain reaction (PCR) confirmed orthopoxvirus infection.
• The clinical presentation and diagnostic results indicated monkeypox.

Implications:

• This case highlights monkeypox as a differential diagnosis in patients with genital lesions and rash, even those on PrEP.
• Paraphimosis can be a rare urological complication of monkeypox infection.
• Early recognition and diagnosis are crucial for managing MPXV and its complications.