Monkeypox Proctitis: A Case of Targeted Treatment With Tecovirimat

Abstract

Monkeypox (MPX) is an exanthematous disease first identified in the 1950s, associated with animals in Central and Western Africa, and has since been found sporadically worldwide. In May 2022, a returning family from Nigeria tested positive for MPX, which marked the onset of the current outbreak. It has now become a disease of concern in most parts of the world. The current standings are nearing 90,000 cases, with numbers increasing daily. The United States reported 29,711 cases so far. The characteristic exanthem of MPX is known to be present ubiquitously on the human habitus, with recent reports describing anogenital and mucosal lesions. Here, we present a rare case of a 43-year-old male presenting with excruciating perianal pain and purulent discharge, found to have proctitis secondary to MPX, and subsequently treated with Tecovirimat, a targeted antiviral therapy.

Keywords: anogenital lesion; hiv; monkeypox virus; muscosal lesion; proctitis; tecovirimat.

Figure 1. Papulopustular lesions on the back.

Figure 2. Perianal lesions.

Figure 3. Perianal lesions with mucopurulent discharge.

Figure 4. Maculopapular lesions surrounding the genital area.

Figure 5. CT abdomen and pelvis depicting rectal thickening and an enlarged lymph node.

CT, computed tomography