Thread by @guerreroespejo

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)
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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)
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#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
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#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.
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MPOX CONJUNTIVITIS, is often a clinical diagnosis that is supported by the results of NAAT of specimens obtained from nonocular sites.
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#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.
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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.
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nej.md/44ILgLy
#sexual