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Monkeypox presenting as supraglottitis in an immunocompromised patient.

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A young man with AIDS developed a severe sore throat, initially mimicking supraglottitis. This was later identified as an early symptom of monkeypox infection, highlighting the need for clinical vigilance.

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Area of Science:

  • Infectious Diseases
  • Virology
  • Public Health

Background:

  • Acquired immunodeficiency syndrome (AIDS) compromises the immune system, increasing susceptibility to opportunistic infections.
  • Monkeypox (MPX) is a viral zoonotic disease with potential for human-to-human transmission.
  • Early recognition of MPX is crucial for effective public health management and containment.

Observation:

  • A patient with AIDS presented with severe sore throat, hoarseness, fever, and myalgia, clinically resembling supraglottitis.
  • Physical examination revealed cervical lymphadenopathy and significant pus over the right tonsil.
  • Flexible nasoendoscopy demonstrated pus tracking to the supraglottis with mucosal ulceration.

Findings:

  • The patient's condition initially improved with treatment for supraglottitis.
  • A suspicious pustule appeared on the patient's hand 24 hours post-admission, confirmed as monkeypox via PCR.
  • This case demonstrates monkeypox presenting with severe pharyngitis as an initial symptom, preceding cutaneous lesions.

Implications:

  • Monkeypox can manifest with severe sore throat as a primary symptom, even without typical cutaneous manifestations.
  • Healthcare professionals must maintain a high index of suspicion for monkeypox in patients with non-specific early symptoms.
  • Early diagnosis and isolation are critical for controlling the spread of monkeypox, a growing public health concern.