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First case report of monkeypox in Brazil: clinical manifestations and differential diagnosis with sexually transmitted infections

Lima, Evelyn Lepka De; Barra, Luiz Alberto Costa; Borges, Luciana Marques Sansão; Medeiros, Lucas Alberto; Tomishige, Marcia Y. S.; Santos, Lucas De Souza Loureiro Abbud; Silva, Anderson José Dias Da; Rodrigues, Camila Cristina Martini; Azevedo, Luiz Cesar Fernandes De; Villas-Boas, Lucy Santos; Silva, Camila Alves Maia Da; Coletti, Thaís Moura; Manuli, Erika R.; Claro, Ingra Morales; Romano, Camila Malta; Ramundo, Mariana Severo; Moutinho, Tomas; Sabino, Ester Cerdeira; Lindoso, José Angelo Lauletta; Figueiredo-Mello, Claudia

Revista do Instituto de Medicina Tropical de São Paulo; Vol. 64 (2022); e54

Universidade de São Paulo. Instituto de Medicina Tropical de São Paulo 2022-10-14

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Title:
First case report of monkeypox in Brazil: clinical manifestations and differential diagnosis with sexually transmitted infections
Author: Lima, Evelyn Lepka De; Barra, Luiz Alberto Costa; Borges, Luciana Marques Sansão; Medeiros, Lucas Alberto; Tomishige, Marcia Y. S.; Santos, Lucas De Souza Loureiro Abbud; Silva, Anderson José Dias Da; Rodrigues, Camila Cristina Martini; Azevedo, Luiz Cesar Fernandes De; Villas-Boas, Lucy Santos; Silva, Camila Alves Maia Da; Coletti, Thaís Moura; Manuli, Erika R.; Claro, Ingra Morales; Romano, Camila Malta; Ramundo, Mariana Severo; Moutinho, Tomas; Sabino, Ester Cerdeira; Lindoso, José Angelo Lauletta; Figueiredo-Mello, Claudia
Subjects: Monkeypox; Sexually Transmitted Diseases
Is Part Of: Revista do Instituto de Medicina Tropical de São Paulo; Vol. 64 (2022); e54
Description: In 2022, an outbreak of monkeypox is being reported in non-endemic areas, with unusual clinical manifestations. The detailed clinical description of the first patient that received the diagnosis of monkeypox in Brazil is reported here, whose clinical manifestations can easily lead to misdiagnosis of sexually transmitted infections. A 41 years old male presented to an emergency room with a vesicular rash with eight days of evolution. He had traveled to Portugal and Spain and reported non-penetrative sexual involvement with three different male individuals. On the third day of symptoms, he sought medical care and received empirical treatment directed to sexually transmitted infections. As the symptoms did not improve, he sought medical attention at an infectious disease referral center presenting, on admission, an ulcerated penile lesion with central necrotic crusts, a disseminated pleomorphic skin rash and an oropharyngeal ulcer. The monkeypox diagnosis was suspected due to the characteristics of the lesions and the history of intimate contact with casual partners, and it was later confirmed by sequencing the almost complete monkeypox genome. The patient was hospitalized for pain control, which required opiate administration. He developed a secondary bacterial infection on the penile lesions, which were treated with oral antibiotics. He was discharged after 14 days, with lesions in process of re-epithelialization. Given the current outbreak, we must consider the possibility of monkeypox in patients with suggestive lesions, anywhere on the body (including the genitals), added to an epidemiological link or history of intimate contact with strangers or casual partners.
Related Titles: https://www.revistas.usp.br/rimtsp/article/view/203528/187482
Publisher: Universidade de São Paulo. Instituto de Medicina Tropical de São Paulo
Creation Date: 2022-10-14
Format: Adobe PDF
Language: English

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First case report of monkeypox in Brazil: clinical manifestations and differential diagnosis with sexually transmitted infections

Universidade de São Paulo. Instituto de Medicina Tropical de São Paulo 2022-10-14

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