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Severe mpox in an immunocompromised, non-traveller South African male
Preethi A John1, Omphemetse Matikane1, Matilda Mphahlele2
1Department of Internal Medicine, Tambo Memorial Hospital, Johannesburg, South Africa.
Abstract:
Mpox is a zoonotic orthopoxvirus infection historically linked to being in endemic regions, travel and close physical contact, including within men who have sex with men (MSM) communities. We report a case of severe mpox in a heterosexual man with advanced human immunodeficiency virus (HIV) disease and no travel history to endemic areas. The patient developed extensive cutaneous disease and transmitted mpox to household contacts, illustrating non-sexual transmission. Management included supportive care and tecovirimat under Section 21 authorisation (a regulatory mechanism in South Africa permitting access to an unregistered medicine) with good clinical response.
Contribution:
This case highlights the changing epidemiology of mpox, the risk of severe disease in immunocompromised patients, household and non-sexual transmission. We also emphasise the importance of early diagnosis, infection control and antiviral therapy when indicated.
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