A 31-YO♂️, #sexually active with 2♂️partners in the previous month: 8 days before redness of the R eye, an itchy perianal rash & rectal pain; scattered, tender, shallow ulcers & pustules on chest (A), abdomen (B), back (C) & perianal (D)
1/9
nej.md/44ILgLy
#proctology
PCR from the perianal vesicel:➕for nonvariola orthopoxvirus DNA.
Species-specific PCR: ➕for #mpox virus, clade II.
The patient reported a new rash with numerous ulcer on his chest, abdomen, and back
MPOX (formerly known as #monkeypox)
2/9
#MolBiol #virology
During the next 2 days, the patient took tecovirimat & reported redness & discomfort of the right eye and become painful
He had learned that mpox had been diagnosed in one of his #sexual partners from the previous month.
Likely MPOX CONJUNTIVITIS
3/9
#ophthalmology #IDtwitter
R eye (A), diffuse bulbar & tarsal conjunctival hyperemia
On eversion of the R lower & upper eyelids (B & C), tarsal conjunctival & subconjunctival petechial hemorrhages (blue arrows) & small-to-medium-sized conjunctival follicles (green arrow)
MPOX CONJUNTIVITIS
4/9
#healthcare
Severely painful, unilateral acute conjunctivitis with small-to-medium-sized follicles developed in this patient
Follicles are associated with a lymphocytic inflammatory response, which is often seen in patients with #conjunctivitis caused by a #viral infection or chlamydia.
5/9
MPOX CONJUNTIVITIS, is often a clinical diagnosis that is supported by the results of NAAT of specimens obtained from nonocular sites.
6/9
#sexually #microbiology
After tecovirimat for 2 weeks: the cutaneous #mpox lesions resolved, and the eye redness decreased.
When the eye redness resolved, the patient was released from home quarantine.
7/9
#AtencionPrimaria #MedTwitter
Manifestations of mpox-related ophthalmic disease (MPXROD) (Figure) may include skin lesions on the eyelid, conjunctivitis, keratitis, or a combination of these conditions.
8/9
nej.md/44ILgLy
#Ophthalmology #emergency
Numerous extracutaneous manifestations of #Mpox : ✔️encephalitis or encephalomyelitis
✔️mpox-related ophthalmic disease
✔️pharyngitis
✔️tonsillitis
✔️epiglottitis
✔️bronchopneumonia
✔️miocarditis
✔️proctitis
✔️lymphadenopathy &
✔️arthritis.
9/9
nej.md/44ILgLy
#sexual
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