First case of mpox detected in Mali in a gold-mining area in 2025 using teledermatology

Mpox, an emerging viral zoonosis, is caused by the mpox virus, which belongs to the Orthopoxvirus genus. Diagnosis largely relies on recognizing characteristic skin manifestations, which gives dermatology a central role in early detection. Here, we report the first confirmed case of mpox in Mali, which was identified through a dermatological teleconsultation in an area with high human mobility along the border.

This case was identified as part of a national teleconsultation program coordinated by the Center for Expertise and Research in Telemedicine and e-Health (CERTES). Clinical data and photographs of the lesions were transmitted via the secure HUG@home platform for dermatological tele-expertise. Diagnostic confirmation was based on real-time PCR performed on a skin specimen at the national reference laboratory, supplemented by viral sequencing.

A 35-year-old man working in artisanal gold mining in a border area between Mali and Guinea presented with a three-week-long rash associated with a febrile syndrome. A remote dermatological examination revealed umbilicated papulovesicular-pustular lesions, which are suggestive of mpox. This led to the patient's immediate isolation and initiation of laboratory testing. The diagnosis was confirmed by PCR 72 hours after the teleconsultation, and sequencing identified a clade IIb virus. An epidemiological investigation identified and monitored 48 contacts for 21 days; no secondary cases emerged during that period. However, three other confirmed cases were subsequently detected in the same area, including a healthcare worker who was exposed while caring for the initial case. The patient made a full recovery after four weeks of follow-up.

The first confirmed case of monkeypox in Mali was detected through teledermatology and led to the identification of additional cases in the same area, suggesting the virus is circulating locally. This observation underscores the potential of dermatological tele-expertise in the early detection of emerging cutaneous diseases and in strengthening epidemiological surveillance in settings with limited resources. Further studies are needed to evaluate the impact of dermatological tele-expertise on diagnostic performance, patient care, and surveillance systems on a larger scale.