Two Cases of Monkeypox-Associated Encephalomyelitis — Colorado and the District of Columbia, July–August 2022

Monkeypox

“… 112 Radiographic imaging of some cases of encephalitis are consistent with acute demyelinating encephalomyelitis but PCR tests of cerebrospinal fluid were negative for poxvirus DNA. 113 Low mood and other mental health issues, including a case of suicide, were reported in Nigeria, 114 although it is unclear whether these conditions are caused by the neurological tropism of monkeypox virus or if they are rather the result of stigma and isolation. In the 2022 outbreak, some novel (albeit rare) severe complications have been identified, including a few sporadic cases of myocarditis, 32 epiglottitis, 32 peritonsillar abscess, 110 rectal wall perforation with associated abscess in patients with proctitis, 33 and haemophagocytic lymphohistiocytosis.…”

Monkeypox encephalitis with transverse myelitis in a female patient

“…On Sept 23, 2022, two cases of monkeypox-associated encephalitis were reported in healthy gay and bisexual men who have sex with men. 11 Encephalitis has been reported as part of the current outbreak and remains a serious and sometimes fatal complication. 2 , 12 Two cases of encephalitis in patients with confirmed monkeypox virus from skin lesions and a report of three cases in suspected monkeypox exist in the literature; these cases have predominantly been in children.…”

Severe Monkeypox in Hospitalized Patients — United States, August 10–October 10, 2022

“…As of this report, monkeypox was a cause of death or contributing factor in five of these deaths; six deaths remain under investigation to determine whether monkeypox was a causal or contributing factor; and in one death, monkeypox was not a cause or contributing factor. ** Health care providers and public health professionals should be aware that severe morbidity and mortality associated with monkeypox have been observed during the current outbreak in the United States ( 6 , 7 ), particularly among highly immunocompromised persons. Providers should test all sexually active patients with suspected monkeypox for HIV at the time of monkeypox testing unless a patient is already known to have HIV infection.…”