(HealthDay News) — Clinical manifestations of monkeypox include mucocutaneous lesions in all patients and systemic features in most patients, which can develop before or after mucocutaneous manifestations, according to a study published online July 28 in The BMJ.
Aatish Patel, M.D., from Guys and St. Thomas’ NHS Foundation Trust in London, and colleagues documented a descriptive case series involving 197 patients (median age, 38 years) with polymerase chain reaction-confirmed monkeypox infection.
The researchers found that all of the patients were men, and 196 identified as gay, bisexual, or other men who have sex with men. All presented with mucocutaneous lesions, most commonly on the genitals or perianal area (56.3 and 41.6 percent, respectively).
A systemic illness was reported by 86.3 percent of patients, with the most common systemic symptoms being fever, lymphadenopathy, and myalgia (61.9, 57.9, and 31.5 percent, respectively). Overall, 61.5 and 38.5 percent of 166 participants developed systemic features before and after onset of mucocutaneous manifestations, respectively.
Twenty-seven patients presented with mucocutaneous manifestations exclusively, without systemic features. Rectal pain, sore throat, and penile edema were reported by 36.0, 16.8, and 15.7 percent, respectively. A total of 35.9 percent of participants had concomitant HIV infection; 31.5 percent of those who were screened for sexually transmitted infections had a concomitant sexually transmitted infection. Twenty patients (10.2 percent) were admitted to the hospital for management of symptoms.
“Urgent research is needed to further understand the modes of transmission of monkeypox virus, particularly around sexual contact, and also the possibility of asymptomatic spread,” the authors write.