Different clinic at monkeypox

A new study published in ‘The BMJ’, has identified important differences in monkeypox symptoms between the current outbreak and previous outbreaks in endemic regions, which the researchers hope the results will help doctors detect infections earlier.

The ace findings are based on 197 cases of monkeypox confirmed at an infectious disease center in London, UK, between May and July 2022. Some of the common symptoms they describe, such as rectal pain and penile swelling (oedema), differ from those described in previous sessions.

Therefore, the researchers recommend that clinicians consider the possibility of monkeypox infection in patients presenting with these symptoms. And they say those with a confirmed monkeypox infection with extensive penile lesions or severe rectal pain “should be considered for continued examination or treatment in hospital.”

Study results

The 197 participants in this study were men (mean age 38), 196 of whom identified as gay, bisexual, or other men who have sex with men. All patients had skin or mucosal lesions, most commonly on the genitals or perianal region.

The majority (86%) of patients reported systemic disease (affecting the whole body). The most common systemic symptoms were fever (62%), swollen lymph nodes (58%) and muscle aches (32%).

And contrary to existing case reports suggesting that systemic symptoms precede skin lesions38% of patients developed systemic symptoms after the appearance of mucocutaneous lesions, while 14% presented lesions without systemic features.

A total of 71 patients reported rectal pain, 33 sore throat, and 31 penile edema, while 27 had oral lesions, 22 had a solitary lesion, and 9 had swollen tonsils.

The authors note that solitary lesions and swollen tonsils were not previously known to be typical features of monkeypox infection and could be confused with other conditions.

Just over a third (36%) of participants also had HIV infection and 32% of people tested for sexually transmitted infections had a sexually transmitted infection.

New symptomatology

A total of 20 (10%) of the participants were admitted to hospital for treatment of symptoms, mainly rectal pain and swelling of the penis. However, no deaths were recorded and no patient required intensive hospital care.

Only one participant had recently traveled to an endemic area, confirming ongoing transmission in the UK, and only a quarter of patients had known contact with someone with confirmed monkeypox infection, raising the question of possibility of transmission by people without symptoms or with very little.

The authors acknowledge some limitations, such as the observational nature of the results, the possible variability of clinical records, and the fact that the data is limited to a single center. However, they state that these findings confirm the current unprecedented community transmission of monkeypox virus among gay, bisexual and other men who have sex with men seen in the UK and many other countries. not endemic.

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