| Journal: | Revista do Instituto de Medicina Tropical de Sao Paulo |
| Database: | |
| System number: | 000547868 |
| ISSN: | 0036-4665 |
| Authors: | Lima, Evelyn Lepka de1 Barra, Luiz Alberto Costa1 Borges, Luciana Marques Sansão1 Medeiros, Lucas Alberto1 Tomishige, Marcia Y. S.1 Santos, Lucas de Souza Loureiro Abbud1 Silva, Anderson José Dias da1 Rodrigues, Camila Cristina Martini1 Azevedo, Luiz Cesar Fernandes de1 Villas Boas, Lucy Santos2 Silva, Camila Alves Maia da2 Coletti, Thaís Moura2 Manuli, Erika R.2 Claro, Ingra Morales2 Romano, Camila Malta2 Ramundo, Mariana Severo2 Moutinho, Tomas2 Sabino, Ester Cerdeira2 Lindoso, José Angelo Lauletta1 Figueiredo Mello, Claudia1 |
| Institutions: | 1Instituto de Infectologia Emílio Ribas, São Paulo, São Paulo. Brasil 2Universidade de São Paulo, Faculdade de Medicina, São Paulo, São Paulo. Brasil 3Imperial College London, MRC Centre for Global Infectious Disease Analysis, London. Reino Unido |
| Year: | 2022 |
| Volumen: | 64 |
| Country: | Brasil |
| Language: | Inglés |
| English abstract | 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. |
| Keyword: | Monkeypox, Sexually transmitted diseases |
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