SHM Converge Scientific Abstract ePoster Gallery-Monkeypox: A Case Series of a Rapidly Emerging Infectious Entity

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This case series describes three patients with monkeypox, highlighting the wide variability in presentation and the importance of recognizing atypical symptoms. Human monkeypox is a rapidly emerging infectious disease and was declared a public health emergency by the World Health Organization. Because routine smallpox vaccination has ceased, population immunity is limited, contributing to re-emergence.<br /><br />The first patient, a 47-year-old man, initially presented with an infected hand wound and later developed a diffuse rash. After reporting recent skin-to-skin contact at a pool party, monkeypox was confirmed by PCR from lesions. He received supportive care and isolation instructions.<br /><br />The second patient, a 33-year-old HIV-positive man, presented with fever, chills, and severe rectal pain. He had multiple recent sexual and close-contact exposures. Workup showed elevated inflammatory markers and a high RPR titer. He was found to have rectal lesions, then developed a diffuse papular rash that tested positive for monkeypox. He was also treated for latent syphilis and gonorrhea and improved after five days.<br /><br />The third patient, a 36-year-old man, presented with painful defecation and urinary difficulty. Imaging showed rectal and anal wall thickening, and examination revealed perianal and anal canal lesions. Biopsies showed ulceration and necrosis, and cultures grew anaerobes. He later developed a diffuse papulopustular rash confirmed as monkeypox and was treated for gonorrhea and latent syphilis.<br /><br />Across cases, presentations ranged from localized lesions and hand infection to proctitis-like symptoms and diffuse rash. Some patients had rectal wall thickening and pelvic adenopathy on CT. The authors emphasize that monkeypox lesions often evolve from pustules to umbilication, scabbing, and resolution. Clinicians should take thorough social and sexual histories, consider monkeypox in variable presentations, and ensure prompt isolation to reduce community spread.

Asset Subtitle

Nathan DeRon Jr.

Meta Tag

Author List Julie Alexander, Nathan DeRon Jr.

Category Clinical Vignettes

Concept Mpox

Concept Rash

Concept PCR Test

Concept Infection Control

Concept Isolation

Distinguished Non-Finalist

Presenter Organization Methodist Health System of Dallas

Presenting Author Nathan DeRon Jr.

Track Adult

Keywords

monkeypox

case series

atypical presentation

proctitis

papulopustular rash

PCR confirmation

public health emergency

HIV-positive patient

rectal lesions

isolation precautions

Mpox

Rash

PCR Test

Infection Control

Isolation