Monkeypox virus infection mimicking primary syphilis.

Area of Science:

• Dermatology
• Infectious Diseases
• Virology

Background:

• Monkeypox (MPX) virus infections typically present with a generalized rash.
• Genital manifestations can occur but are often accompanied by other symptoms.

Observation:

• A case series identified a patient with MPX presenting solely with a single genital ulcer.
• The ulcer exhibited specific characteristics: raised borders, yellowish crusty base, and bilateral inguinal lymphadenopathy.
• Diagnostic tests confirmed MPX DNA and Staphylococcus aureus, while syphilis and other STIs were negative.

Findings:

• The patient's presentation mimicked primary syphilis and other STIs.
• Localized MPX infection can occur without systemic symptoms.
• Complete resolution with scarring was observed within one month.

Implications:

• MPX should be included in the differential diagnosis for genital ulcers, even with localized or atypical presentations.
• Clinicians must maintain a high index of suspicion for MPX in patients presenting with STI-like symptoms.
• This case highlights the importance of considering MPX in the broader spectrum of sexually transmitted infections.