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Case Report: Mpox - Not Just a Rash.

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Mpox (monkeypox) can present with diverse symptoms beyond rash, including myocarditis and proctitis. Early clinical suspicion is crucial for diagnosing this emerging viral infection, especially in co-infected patients.

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Area of Science:

  • Virology
  • Epidemiology
  • Clinical Medicine

Background:

  • Mpox (formerly monkeypox) is an Orthopoxvirus causing zoonotic and human-to-human transmission.
  • The 2022 global outbreak marked the first pandemic-significant mpox event.
  • Clinical manifestations and outcomes vary by viral clade.

Observation:

  • Five confirmed mpox cases in Northern California (June-July 2022) exhibited diverse presentations.
  • Observed conditions included myocarditis, pharyngitis, epididymitis, and proctitis.
  • Significant overlap with HIV infection and high rates of concurrent STIs were noted.

Findings:

  • Mpox presents heterogeneously, extending beyond classic rash and systemic symptoms.
  • Myocarditis, pharyngitis, epididymitis, and proctitis are potential mpox manifestations.
  • Co-infection with HIV and other STIs is common in mpox cases.

Implications:

  • Clinicians require updated guidance for diagnosing and managing mpox.
  • High suspicion is warranted for oropharyngeal/genital lesions, proctitis, or rash.
  • Understanding mpox's varied clinical spectrum is vital for effective public health response.