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Anal Monkeypox Disease: Description of 65 Cases
Benjamin Le Vavasseur1, Sihem Bendaoud2, Sarah Taieb2
1Department of Internal Medicine and Infectious Diseases, Diaconesses Croix Saint-Simon Hospital, Paris, France.
Diseases of the Colon and Rectum
|October 25, 2023
Summary
Monkeypox proctological symptoms, including painful anal ulcerations and proctitis, are frequent in the current outbreak, likely due to sexual transmission. Recognition of rectal ulcerations is crucial to prevent unnecessary surgery.
Area of Science:
- Infectious Diseases
- Proctology
- Epidemiology
Background:
- Monkeypox (MPX) is an endemic zoonosis in Africa caused by orthopoxvirus clades.
- A global outbreak in 2022 highlighted a novel transmission route, necessitating further research.
Purpose of the Study:
- To describe anal symptoms and outcomes in patients with Monkeypox virus infection.
- To investigate the association with sexually transmitted infections (STIs) and patient outcomes.
Main Methods:
- Observational study of consecutive patients with confirmed anal MPX infection.
- Data collected on anal symptoms, severity, STIs, and clinical outcomes.
- Study conducted at a single proctology center between June 16 and July 26, 2022.
Main Results:
- Sixty-five men (mean age 39.6 years) were included, with 97% reporting sexual transmission as men who have sex with men.
- Common symptoms included painful perianal (64.6%), anal (43%), and rectal ulcerations (38.4%), and proctitis (75.4%).
- Complete symptom resolution occurred within 12 days; 3 patients required hospitalization.
Conclusions:
- Proctological symptoms are a frequent manifestation of the current Monkeypox outbreak, strongly linked to sexual transmission.
- Rectal ulcerations mimicking high intersphincteric suppuration were observed, emphasizing the need for accurate diagnosis to avoid unnecessary surgical intervention.
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