SHM Converge Scientific Abstract ePoster Gallery-Hard to Swallow: A Case of Severe Monkeypox Infection

Pdf Summary

This case report describes a 32-year-old man with well-controlled HIV and asthma who was hospitalized with severe monkeypox infection. He initially presented with malaise, myalgias, sore throat, and an umbilical rash after recent travel to New Orleans, where a contact later tested positive for monkeypox. He returned with worsening throat pain, dysphagia, odynophagia, and inability to tolerate oral intake. On exam, he had diffuse umbilicated lesions involving the face, lips, tongue, extremities, genitals, and later the rectum, along with neck tenderness and low-grade fever. Testing confirmed monkeypox, and he was also found to have group C streptococcal pharyngitis; his CD4 count was 390.<br /><br />During hospitalization he developed hematochezia, mucous stools, and rectal lesions, suggesting proctitis and more extensive disease. Infectious Disease recommended tecovirimat (Tpoxx), which was obtained through the Georgia Department of Health. After treatment, his lesions began to crust, and his throat symptoms and oral intake improved. He was planned for a 14-day course and outpatient follow-up.<br /><br />The report also reviews monkeypox epidemiology and CDC treatment guidance. Monkeypox is a zoonotic orthopoxvirus historically endemic to Central and West Africa, but it spread globally in 2022, leading to thousands of cases worldwide, including many in Georgia. CDC indications for tecovirimat include severe disease or high-risk involvement, such as infection in young children, pregnant or breastfeeding patients, immunocompromised individuals, and lesions affecting special hazard areas like the mouth, anus, or eyes.<br /><br />The key conclusion is that hospitalists must recognize severe monkeypox manifestations and know when to use antiviral therapy versus supportive care, especially during an evolving outbreak.

Asset Subtitle

Viniya Patidar

Meta Tag

Author List Bashir A. Geer, Dawn C. Howard, Deniece Johnson, Prathima Pangulur, Viniya Patidar

Category Clinical Vignettes

Concept Mpox

Concept Severe Disease

Concept Tecovirimat

Concept Skin Lesion

Concept Supportive Care

Distinguished Non-Finalist

Presenter Organization Emory University School of Medicine

Presenting Author Viniya Patidar

Track Adult

Keywords

monkeypox

tecovirimat

HIV

proctitis

orthopoxvirus

hospitalization

dysphagia

odynophagia

skin lesions

CDC treatment guidance

Mpox

Severe Disease

Tecovirimat

Skin Lesion

Supportive Care