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Vaccinia Virus Infection & Temporal Analysis of Virus Gene Expression: Part 2
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Atypical Mpox Cutaneous Presentation After Full Vaccination.

Celine M Schreidah1, Blair A Jenkins2,3, Megan H Trager2

  • 1Columbia University Vagelos College of Physicians & Surgeons, New York, NY.

The American Journal of Dermatopathology
|February 21, 2025
PubMed
Summary
This summary is machine-generated.

Mpox vaccination may not fully prevent infection in immunosuppressed individuals. This case highlights atypical mpox presentation in a vaccinated, immunocompromised patient, emphasizing diagnostic challenges.

Keywords:
atypical presentationbreakthroughfull vaccinationmonkeypoxmpoxsmallpox

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Area of Science:

  • Immunology
  • Infectious Diseases
  • Dermatology

Background:

  • The 2022-2023 mpox outbreak prompted a global health emergency declaration.
  • Smallpox vaccination has reduced mpox incidence and severity in the general population.
  • The efficacy of mpox vaccination in immunosuppressed individuals remains unclear.

Purpose of the Study:

  • To report an atypical case of cutaneous mpox in a vaccinated, immunosuppressed patient.
  • To discuss the diagnostic challenges posed by unusual mpox presentations.
  • To review the workup for mpox in immunocompromised populations.

Main Methods:

  • Case report of a single patient.
  • Review of relevant medical literature.
  • Analysis of diagnostic workup.

Main Results:

  • An HIV-negative, immunosuppressed patient, fully vaccinated against mpox, developed an isolated subcutaneous neck mass.
  • The presentation mimicked other conditions, creating a diagnostic dilemma.
  • Diagnostic workup confirmed cutaneous mpox.

Conclusions:

  • Mpox can present atypically even in fully vaccinated, immunosuppressed individuals.
  • Early and comprehensive diagnostic evaluation is crucial for immunocompromised patients with suspected mpox.
  • Further research is needed to understand vaccination effectiveness in immunosuppressed populations.