How does monkeypox cause wounds? So we read

Due to the presence of monkeypox cases in Spain and the rest of European countries, Spanish dermatologists have been invited to participate in the data collection of the disease from May 28th to July 14th, 2022. Only those patients who showed a positive result for every sample taken were included in this study orthopox virus hey monkeypox virus (mpxiv). A survey was conducted via the REDCap platform, collecting clinical, demographic and epidemiological data.

Pseudopustules and severe pain

Results showed that most lesions started in the genital, facial, perianal, or extremity areas. Only a small percentage of patients (11%) had localized or isolated lesions.

One of the most important aspects that we contribute to is the description of the underlying monkeypox lesion. Although pustules are commonly discussed, these lesions have been observed to form pseudopustules since their contents are mainly firm and white.

In addition, the lesions usually have a necrotic center and an erythematous halo, which gives them their characteristic appearance. Later, as these lesions develop, they may take on a purulent, necrotic, or even ulcerated appearance. This is important information not only for dermatologists but also for other healthcare professionals to help identify and not be used to assess skin lesions.

Symptoms of the lesions reported by patients varied, but some were very painful and associated with swollen regional lymph nodes (lymphadenopathy).

Other symptoms: swelling, fever, fatigue…

Besides skin lesions, other less common but relevant manifestations were: hoarseness (inflammation of the distal part of the fingers), direct involvement of the oral or genital mucosa, and proctitis (inflammation of the rectal mucosa). These lesions can be isolated, associated or early in appearance with skin lesions, underscoring the importance of knowing their relationship to the virus in order to make a correct diagnosis.

All patients included in the study presented systemic symptoms, mainly swollen lymph nodes (56%), fever (54%), myalgia (44%), fatigue (44%) and headache (32%). Most often, these symptoms appear simultaneously or 2 to 3 days before the appearance of skin lesions.

Few hospitalizations and no deaths

The need for hospitalization was almost real (only 4 cases, 2% of the total) and in some of these cases it was for pain control or for preventive monitoring for the presence of severe symptoms (severe dysphagia, conjunctivitis and suspected perforation). went. , No patient died.

All patients in our series were male. In addition, all reported having sex with other men (99%), and most had multiple sex partners in the weeks prior to onset of symptoms.

Other interesting epidemiological data found that 54% of patients had presented a diagnosis of a sexually transmitted infection (STI) in the previous months, 34% had used some type of drug in their sexual relationship. Chemex And 42% were HIV positive. The use of PrEP (pre-exposure prophylaxis) was also common in HIV-negative patients. In addition, another concomitant STI was found at the time of monkeypox presentation in 76 percent of cases.

The presence of concomitant HIV infection (with good virologic control) or prior vaccination against smallpox was not associated with greater or lesser disease severity.

Regarding the incubation period, the mean number of days from suspected exposure in our series (in patients where exposure timing can be accurately determined) to symptom onset was 6 days (with an interval between 4 and 9). .

How does an infection take place and who is infected?

Skin lesions are an important manifestation of infection. Onset is usually solid to pseudopustular that later becomes necrotic and may ulcerate. Systemic symptoms occur in a large proportion of infected patients and some represent an important finding for the early detection of cases; Especially those who have been in close contact with another diagnosed person.

In most cases it is a mild disease. Particular attention should be paid to the most unusual symptoms that may appear in isolation or be treated more complexly, such as proctitis, airway injury, and leukorrhea.

Co-infection with other STIs is often found in patients diagnosed with monkeypox and should therefore be actively investigated.

Although the current outbreak is mainly occurring in men who have sex with other men and engage in risky behavior, it is possible that with an increase in incidence there are cases with a different profile in patients or populations. Hm.

However, with due care to avoid stigma, any control efforts (information, vaccinations…) with the help of LGBTIQ+ groups should primarily target this most affected group in order to protect them and offer an optimal opportunity to contain the spread . the breakout. Ignoring the importance that all health professionals, regardless of their level of expertise, know the disease and its clinical features in order to diagnose the pathology in anyone susceptible to contagion.

At this time, our main weapon in controlling the outbreak is to encourage and urge patients who have been diagnosed to adhere to the recommended length of isolation. In addition, the vaccine can help prevent exposure to confirmed cases or someone who may be at higher risk of developing the disease.

To increase our knowledge of this disease and to answer the questions that we still ask ourselves, such as: persistence of the virus in fluids or mucous membranes, through the most appropriate treatment of asymptomatic people or our patients Possible infections from

This article was originally published by Science Media Center Spain.