Monkeypox infection presenting as genital lesions
How to cite this article: Rivera-Ruiz I, Corona-Mata D, Camacho-Espejo Á. Monkeypox infection presenting as genital lesions. Indian J Dermatol Venereol Leprol doi: 10.25259/IJDVL_790_2022
A 40-year-old HIV (human immunodeficiency virus) positive man was admitted to our emergency department with a five day history of painful genital lesions, fever, myalgia, arthralgia and lower back pain. Ten days earlier, he had unprotected intercourse with other men as a sex worker. On physical examination, several umbilicated papules and one ulcerated lesion were observed affecting the genital area [Figures 1]. The patient also presented with painful bilateral inguinal lymphadenopathy. A swab was taken from the ulcer for sexually transmitted infections (polymerase-chain-reaction for Chlamydia trachomatis, Haemophilus ducreyi, syphilis and herpes virus) and the patient was initiated on empiric antiviral therapy with famciclovir for a possible herpes virus infection. Due to epidemiological context, clinical manifestations and a negative polymerase-chain-reaction for sexually transmitted infections, we suspected monkeypox infection. Polymerase-chain-reaction assays of swabs obtained from the lesions were positive for monkeypox. Seven days after the initial presentation, the distal ulcer had a superinfection by Staphylococcus aureus and was treated with amoxicilin/clavulanic acid and within six weeks after his initial presentation, the patient’s lesions had abated with only a scar remaining in the distal lesion.
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