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. 2022 Oct;30(4):575-581.

Approaching monkeypox: a guide for clinicians

Heidi M Torres  1 , Grant Ellsworth  1 , Jason Zucker  2 , Marshall J Glesby  1
Affiliations

Approaching monkeypox: a guide for clinicians

Heidi M Torres et al. Top Antivir Med. 2022 Oct.

Abstract

The 2022 outbreak of monkeypox virus infection has expanded far beyond regions in which the disease was previously endemic. Monkeypox has a wide range of manifestations, some of which are unique to this outbreak. Novel clinical presentations, testing limitations, and a lack of available treatments have contributed to delays in recognition, diagnosis, and treatment of monkeypox. As health care workers and governments fight this rare viral infection, which may become a routine diagnosis, early recognition of potential signs and symptoms along with appropriate testing is essential to prevent continuing spread and potential endemicity.

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Figures

Figure 1.
Figure 1.
Flowchart for an approach to monkeypox virus infection.
Figure 2.
Figure 2.
A and B: Pustule-like lesions on a limb and dorsal hand. C: Cluster of papules, some with umbilication.
Figure 3.
Figure 3.
A: Umbilicated lesion on penis. B: Cluster of papules in the perianal region, many with umbilication.
Figure 4.
Figure 4.
Morbilliform rash on buttocks (A), lower trunk (B), and forearm (C). D: Morbilliform rash on thigh with area of confluent rash.
Figure 5.
Figure 5.
A: Ulcerations on palate and tonsil. B: Ulceration on penis. C: Ulcerations on penis and pubis.
Figure 6.
Figure 6.
Complications of monkeypox. A: Secondary infection of chin lesions. B: Appearance of infection shown in panel A 5 days later. C: Fissure and ulceration in the perianal region surrounded by papules and umbilicated lesions.
Figure 7.
Figure 7.
Scabbed lesions. A: On penis; note the varying stages of lesions present with adjacent pustule. B: Progression of ulcerated lesions shown in Figure 5C; note the reepithelization of the penile shaft lesion and scabbing of the pubic ulceration. C: Scabbed lesion.
Figure 8.
Figure 8.
A, B, and C: Resolution of lesions.
See this image and copyright information in PMC

References

    1. Monkeypox. Centers for Disease Control and Prevention. https://www.cdc.gov/poxvirus/monkeypox/. 2022. Accessed October 15, 2022.
    1. Monkeypox. World Health Organization. https://www.who.int/news-room/fact-sheets/detail/monkeypox. 2022. Accessed October 15, 2022.
    1. Benatti SV, Venturelli S, Comi N, Borghi F, Paolucci S, Baldanti F. Ophthalmic manifestation of monkeypox infection. Lancet Infect Dis. 2022;22(9):1397. - PMC - PubMed
    1. Basgoz N, Brown CM, Smole SC, et al. Case 24-2022: a 31-year-old man with perianal and penile ulcers, rectal pain, and rash. N Engl J Med. 2022;387(6):547–556. - PubMed
    1. Patrocinio-Jesus R, Peruzzu F. Monkeypox genital lesions. N Engl J Med. 2022;387(1):66. - PubMed

MeSH terms