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Monkeypox Presenting as an Isolated Finger Infection: A Case Report
Yasmine Soubra1, Anirudh Sudarshan2, Amanda C Seymour2
1Texas A&M College of Medicine, Houston, Texas.
JBJS Case Connector
|June 12, 2025
Summary
This case highlights monkeypox mimicking a bacterial infection in an HIV patient. Early recognition of monkeypox is crucial to prevent unnecessary surgical interventions.
Area of Science:
- Infectious Diseases
- Dermatology
- Virology
Background:
- Monkeypox (Mpox) can present with atypical symptoms.
- Human immunodeficiency virus (HIV) may influence disease presentation.
- Early diagnosis of viral infections is critical for appropriate management.
Purpose of the Study:
- To describe an unusual case of monkeypox presenting as an isolated finger abscess.
- To emphasize the importance of considering viral etiologies in unexplained skin lesions.
- To highlight the diagnostic challenges in early-stage monkeypox.
Main Methods:
- Case report of a 50-year-old male with HIV.
- Initial presentation with an isolated dorsal index finger abscess.
- Surgical debridement, histopathology, and polymerase chain reaction (PCR) for diagnosis.
- Clinical follow-up and wound management.
Main Results:
- Surgical pathology revealed poxvirus features, but no pus was initially found.
- Subsequent development of generalized pustules confirmed as monkeypox via PCR.
- The surgical site deteriorated, requiring a second debridement.
- The finger lesion healed within 3 months with local wound care, preserving function.
Conclusions:
- Monkeypox can initially mimic a bacterial abscess, delaying diagnosis.
- This case underscores the need for vigilance in recognizing early, non-vesicular monkeypox signs.
- Timely diagnosis and appropriate management can prevent unnecessary surgical procedures.
