Monkeypox Symptoms and Treatment

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Monkeypox virus is a zoonotic Orthopoxvirus and a possible biothreat agent that causes human disease with varying morbidity and mortality. Today, monkeypox is considered the most important orthopoxvirus infection in human beings since the eradication of smallpox. It is a potentially severe illness that begins with a high fever, followed by the development of a characteristic rash.

Clinical presentation

After exposure to the virus and infection, there is an incubation period that varies between 6 and 14 days, followed by a prodromal period of about 1-3 days before the appearance of the typical maculopapular rash. During this prodrome phase the affected individual can experience fever, malaise and swollen lymph nodes, with possible occurrence of other symptoms such as sweats, headache, backache, shortness of breath, sore throat and cough.

Lymph node enlargement can arise in the submandibular, cervical or inguinal regions, and such lymphadenopathy is important when distinguishing mokeypox from smallpox, as it is not a common feature in the latter disease. It is observed in approximately 90% of all human monkeypox infections, and the enlarged lymph nodes are tender, firm and sometimes even painful.

After the prodrome period, typical maculopapular rash develops with mean diameter of the skin lesions from 0.5 to 1 centimeter. The number of lesions can range from a few to thousands, and during a period of 2-4 weeks they progress from macules to papules, vesicles, pustules and finally a crusting phase characterized by umbilication, scabbing, and desquamation.

The lesions most often affect oral mucous membranes (in 70% of cases) and genitalia (in 30% of cases), but can also affect eyelids and the cornea. Extracutaneous manifestations, such as secondary skin or soft-tissue infections, have been observed in 19% of unvaccinated monkeypox patients. Encephalitis can also arise, but in less than 1% of all cases.

Therapy and management

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