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Case Report: Mpox – Not Just a Rash
ABSTRACT.
Mpox (formally monkeypox) is an Orthopoxvirus associated with both zoonotic and person-to-person spread. Human mpox classically presents with rash and systemic symptoms. Although sporadic outbreaks of mpox have occurred worldwide, the 2022 outbreak is the first of pandemic significance. Thousands of geographically dispersed cases were reported beginning in May 2022. The clinical presentations and outcomes of mpox infection have varied greatly based on viral clade. Further guidance is needed for clinicians to diagnose and treat this emerging infection. We present five clinical vignettes of confirmed cases diagnosed in June and July 2022 in northern California to demonstrate the range of mpox disease, including myocarditis, pharyngitis, epididymitis, and proctitis. We note a significant overlap with HIV infection and a high rate of concurrent sexually transmitted infection. Given the heterogenous presentations of mpox disease, clinicians should maintain a high degree of suspicion in patients with oropharyngeal or genital lesions, proctitis, or new rash.
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Author Notes
Authors’ addresses: Caitlin A. Contag, Abraar Karan, Krithika Srinivasan, and Jorge L. Salinas, Division of Infectious Diseases, Department of Medicine, Stanford University, Palo Alto, CA, E-mails: cacontag@stanford.edu, abraar@stanford.edu, ksrini0@stanford.edu, and jlsalinas@stanford.edu. Lucy Studemeister, Rajat Bansil, Isabel Fong, Supriya Narasimhan, Joseph D. Cooper, and Harleen Sahni, Santa Clara Valley Medical Center, Division of Infectious Diseases, AIDS Medicine, Mycobacterial Diseases, and International Health, San Jose, CA, E-mails: lucy.studemeister@hhs.sccgov.org, rajat.bansil@hhs.sccgov.org, isabel.fong@hhs.sccgov.org, supriya.narasimhan@hhs.sccgov.org, joseph.cooper@hhs.sccgov.org, and harleen.sahni@hhs.sccgov.org.