Monkeypox – a description of the clinical progression of skin lesions: a case report from Colorado, USA

Ortiz-Martínez, Yeimer; Rodríguez-Morales, Alfonso J.; Franco‐Paredes, Carlos; Chastain, Daniel B; Gharamti, Amal; Barahona, Lilian Vargas; Henao‐Martínez, Andrés F.

doi:10.1177/20499361221117726

Cited by 46 publications

(67 citation statements)

References 13 publications

(16 reference statements)

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“…However, the current evidence is not de nitive since contact transmission is also a common route for MPV transmission. Moreover, lesions reported patients in the current outbreak are mostly detected in the anogenital region [16,24,25], which can signi cantly contribute to transmitting the infection since contacting such lesions during sexual activities is inevitable. Accordingly, future studies might be needed to explain further the pathogenesis of MPV presence in the seminal uid.…”

Section: Discussionmentioning

confidence: 99%

Monkeypox viral detection in semen specimens of confirmed cases: A systematic review and meta‐analysis

Reda

Abdelaal

Brakat

et al. 2022

Journal of Medical Virology

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Background The current literature shows increasing concerns about potential seminal transmission of monkeypox virus (MPV). Accordingly, we aimed to understand better the potential presence of MPV in the seminal uids and others specimens obtained from monkeypox (MPX) cases.Methods On June 26, 2022, a systematic search of the literature was conducted across PubMed, Scopus, Web of Science, EMBASE, ScienceDirect, ProQuest, EBSCOHost-Academic Search Complete, and Google Scholar to nd articles that examine the presence of MPV in seminal uid of con rmed cases . The search was updated on August 12 to include newly published articles. The prevalence of MPV DNA presence in the seminal uid and other specimens was pooled in a meta-analysis and results were presented as effect sizes and their corresponding 95% con dence intervals (CI). The quality of included articles was assessed using the National Institute of Health tool.Results Eight articles (including 585 MPX-con rmed patients) were included. Only four studies were eligible for a meta-analysis, and the individual positivity rate of MPV DNA in semen specimens ranged from 61.11% to as high as 90.62%, while the pooled rate was 78% (95% CI: 62-93%; I2=61.93%) among 91 examined patients. Moreover, the pooled positive rate of MPV DNA was the highest in rectal samples (100%; 95%CI: 94-100%), followed by urinary (31%; 95%CI: 1-61%), nasopharyngeal (28%; 95%CI: 24-32%), and blood/plasma (8%; 95%CI: 6-10%) samples, respectively. Furthermore, two articles also investigated the infectivity of MPV particles detected in seminal specimens by testing their replication competence. Culturing MPV was successful in one out of three patients included in these studies. Also, based on available evidence, the positivity of MPV in semen specimens can be observed early and up to 19 days after symptoms onset.Conclusions MPV is highly prevalent in seminal specimens of MPX cases, further corroborating the role of sexual transmission of the disease. However, further evidence is still needed to shed more light on the replication competence of these particles.

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Section: Discussionmentioning

confidence: 99%

Monkeypox viral detection in semen specimens of confirmed cases: A systematic review and meta‐analysis

Reda

Abdelaal

Brakat

et al. 2022

Journal of Medical Virology

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“…This pathogen causes a two-clinical stage illness, including a prodrome during its invasive period and a cutaneous phase defined as the skin eruption [ 7 ]. Although described over decades, the current ongoing outbreak outside Africa seems to present atypical clinical manifestations compared to cases reported before 2022 in endemic countries [ 8 – 10 ]. The MPXV, taxonomically, is currently part of the genus Orthopoxvirus, which belongs to the subfamily Chordopoxvirinae in the family Poxviridae.…”

Section: Introductionmentioning

confidence: 99%

Clinical features, hospitalisation and deaths associated with monkeypox: a systematic review and meta-analysis

Benítes-Zapata

Ulloque-Badaracco

Alarcón-Braga

et al. 2022

Ann Clin Microbiol Antimicrob

104

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Introduction A multicountry monkeypox disease (MPX) outbreak began in May 2022 in Europe, leading to the assessment as a potential Public Health Emergency of International Concern (PHEIC) on June 23, 2022. Some observational studies have partially characterised clinical features, hospitalisations, and deaths. However, no systematic reviews of this MPX outbreak have been published. Methods We performed a systematic review with meta-analysis, using five databases to assess clinical features, hospitalisations, complications and deaths of MPX confirmed or probable cases. Observational studies, case reports and case series, were included. We performed a random-effects model meta-analysis to calculate the pooled prevalence and 95% confidence interval (95% CI). In addition, we carried out a subgroup analysis according to the continents and a sensitivity analysis excluding studies classified as having a high risk of bias. Results A total of 19 articles were included, using only 12 articles in the quantitative synthesis (meta-analysis). For 1958 patients, rash (93%, 95% CI 80–100%), fever (72%, 95% CI 30–99%), pruritus (65%, 95% CI 47–81%), and lymphadenopathy (62%, 47–76%), were the most prevalent manifestations. Among the patients, 35% (95% CI 14–59%) were hospitalised. Some 4% (95% CI 1–9%) of hospitalised patients had fatal outcomes (case fatality rate, CFR). Conclusion MPX is spreading rapidly, with a third of hospitalised patients, but less than 5% with fatal outcomes. As this zoonotic virus spreads globally, countries must urgently prepare human resources, infrastructure and facilities to treat patients according to the emerging guidelines and the most reliable clinical information.

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“…(Anderson et al, 2003) Recently published literature has highlighted the need for clinical follow-up in MPX patients to allow early detection and treatment of bacterial superinfected lesions; however large patient series are missing to estimate this complication risk. (Ortiz-Martínez et al, 2022) The effect of HIV on the severity of Monkeypox is unknown. Although HIV positivity has not been associated with higher symptom severity in patients with good immunevirologic control, an exuberant cutaneous presentation has been described in an acute HIV setting.…”

Section: Discussionmentioning

confidence: 99%

Monkeypox infection and bacterial cellulitis: a complication to look for

Sousa¹,

Frade²,

Patrocínio³

et al. 2022

International Journal of Infectious Diseases

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Monkeypox – a description of the clinical progression of skin lesions: a case report from Colorado, USA

Cited by 46 publications

References 13 publications

Monkeypox viral detection in semen specimens of confirmed cases: A systematic review and meta‐analysis

Monkeypox viral detection in semen specimens of confirmed cases: A systematic review and meta‐analysis

Clinical features, hospitalisation and deaths associated with monkeypox: a systematic review and meta-analysis

Monkeypox infection and bacterial cellulitis: a complication to look for

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