Monkeypox Infection: Another Great Imitator

Rash and anogenital lesions are being commonly seen, but unusual manifestations — such as a single genital ulcer or lesions on the palms and soles — may occur.

The ongoing outbreak of monkeypox (MPX) has distinctive features (NEJM JW Infect Dis Aug 2022 and Lancet Infect Dis 2022 Jul 1; [e-pub]). Now, a case series of 528 patients from 16 countries describes typical as well as unusual manifestations.

Notable findings include:

98% of patients were gay or bisexual men; 2% were heterosexual.
9% reported previous smallpox vaccination.
Transmission through sexual activity was suspected in 95%.
Rash (macules, pustules, vesicles, crusted lesions) was present in 95%, most often in the anogenital region (73%); other sites included the face (25%) and palms or soles (10%). Most individuals had <10 lesions; 39% had <5 lesions.
Other presenting findings included a single genital ulcer (10%); anorectal mucosal involv…

Reviewing Author

Rajesh T. Gandhi, MD

Disclosures

Grant/Research SupportNIH

Editorial BoardsUpToDate; ID Images (idimages.org); Infectious Diseases Society of America COVID-19 Treatment Guidelines; International Antiviral Society–USA (Guidelines Committee)

Leadership Positions in Professional SocietiesHIV Medicine Association; Infectious Diseases Society of America (Board of Directors)

Rajesh T. Gandhi, MD

Disclosures

Grant/Research SupportNIH

Editorial BoardsUpToDate; ID Images (idimages.org); Infectious Diseases Society of America COVID-19 Treatment Guidelines; International Antiviral Society–USA (Guidelines Committee)

Leadership Positions in Professional SocietiesHIV Medicine Association; Infectious Diseases Society of America (Board of Directors)

Monkeypox Infection: Another Great Imitator

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Reviewing Author