Mpox presents typically with macular papular body rashes with similar-looking sores in genital or oral areas. It may be missed, or wrongly managed as sexually transmitted infections (STI), especially in settings where symptom-based treatment practices are sufficient for care. We describe a 40-year-old cisgender male, heterosexual Nigerian who developed some rash in the genital region associated with penile swelling. It was suspected to be syphilis and managed with presumptive antibiotics. Laboratory investigation (PCR) confirmed that it was a Mpox disease, and VDRLT was negative. Notably, in this case, the early symptoms were a paradigm case of Mpox disease presenting as an STI, which syndromically conformed more to an STI than the case definition for a suspected case of Mpox in our setting. Consequently, the expected early containment activities were delayed. This increased the potential of further disease spread. An Update of the standard case definition as well as a reclassification of the disease as a possible STI is recommended for enhanced surveillance, increased case detection, and reduction in the burden of unrecognized cases.

Background: Monkey pox (Mpox) is a zoonotic viral illness that is endemic to Africa. In contrast to earlier years, the current Mpox outbreak has had an unusually rapid worldwide spread in terms of the number of cases, and most of these cases were among Men who have Sex with Men (MSM). The study aims to assess the knowledge, attitude, practice of infection prevention, and stigma of Mpox disease among members of the MSM community. Methods: The study was a cross-sectional design. A self-administered questionnaire was given to 498 respondents. Results: The mean age of the respondents was 30 years; twenty-three (4.6%) of the total respondents identified themselves as female gender. Urban dwellers were 344 (69.1%). Respondents had a good knowledge of both Mpox disease and transmission; an average knowledge of Mpox symptoms; and an average attitude towards prevention and the practice of prevention of Mpox. Age was found to be significantly associated with knowledge of transmission (p-value). Mpox infection was evaluated as a low-risk event by most responses, but the existence of both community stigma and self-stigma if infected were rated as high. Conclusion: The knowledge of Mpox disease and its transmission was good, while the attitude and practice of infection prevention was average. However, the existence of community and self-stigmatization was high; which perhaps may result in the possibility of an iceberg phenomenon of Mpox disease in the MSM community. Community sensitization, advocacy, and key population-friendly services are recommended for the MSM community to improve their general access to healthcare and reduce stigmatisation.