Monkeypox-induced proctitis: a case report of an emerging complication.
Infection. 2023 Feb 07 [Online ahead of print]I

Abstract

PURPOSE

At the outset of the 2022 human monkeypox virus outbreak, the World Health Organization described the self-limited disease as a rash illness associated with nonspecific symptoms such as fever, myalgias, and lymphadenopathy. Historically, the infection caused by this zoonotic virus has presented with rashes primarily on the face, palms, and soles of feet. However, emerging case report literature from the 2022 recent outbreak highlighted more atypical presentations ranging from ocular manifestations to myocarditis.

CASE DESCRIPTION

We present a case of a 32-year-old African American male with a past medical history of poorly controlled acquired immunodeficiency syndrome and external hemorrhoids that presented for worsening rectal pain. The patient was afflicted with diffuse skin lesions even present on his hemorrhoids. Initial imaging significant circumferential rectal thickening consistent with proctitis. Subsequent polymerase chain reaction testing confirmed active monkeypox infection, and a 14-day course of twice daily tecovirimat 600 mg was initiated to treat disseminated monkeypox infection. After improved pain control and starting antiviral treatment, the patient was discharged two days later.

CONCLUSION

As more cases of monkeypox-associated proctitis emerge, clinicians should keep this disease in their differential due to the growing atypical presentations that have diverged from previous patterns to avoid the risk of misdiagnosing another sexually transmitted infection. Additionally, appropriate medical management is still not definitive and requires further development of evidence-based protocols to treat such patients.

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Publisher Full Text (DOI)

Authors+Show Affiliations

Rathore A

Department of Medicine, University of Florida Health Science Center, Jacksonville, FL, 32209, USA. azeem.rathore@jax.ufl.edu.

Kahn C

Department of Medicine, University of Florida Health Science Center, Jacksonville, FL, 32209, USA.

Reich D

University of Florida College of Medicine, Gainesville, FL, 32610, USA.

Qadir N

Edward Via College of Osteopathic Medicine, Auburn, AL, 36832, USA.

Verdecia J

Division of Infectious Disease, University of Florida Health Science Center, Jacksonville, FL, 32209, USA.

House JG

Department of Medicine, University of Florida Health Science Center, Jacksonville, FL, 32209, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

36750482

Citation

Rathore, Azeem, et al. "Monkeypox-induced Proctitis: a Case Report of an Emerging Complication." Infection, 2023.

Rathore A, Kahn C, Reich D, et al. Monkeypox-induced proctitis: a case report of an emerging complication. Infection. 2023.

Rathore, A., Kahn, C., Reich, D., Qadir, N., Verdecia, J., & House, J. G. (2023). Monkeypox-induced proctitis: a case report of an emerging complication. Infection. https://doi.org/10.1007/s15010-023-01987-z

Rathore A, et al. Monkeypox-induced Proctitis: a Case Report of an Emerging Complication. Infection. 2023 Feb 7; PubMed PMID: 36750482.

* Article titles in AMA citation format should be in sentence-case

TY - JOUR T1 - Monkeypox-induced proctitis: a case report of an emerging complication. AU - Rathore,Azeem, AU - Kahn,Cameron, AU - Reich,Daniel, AU - Qadir,Nadim, AU - Verdecia,Jorge, AU - House,Jeffrey G, Y1 - 2023/02/07/ PY - 2022/12/05/received PY - 2023/01/18/accepted PY - 2023/2/7/entrez PY - 2023/2/8/pubmed PY - 2023/2/8/medline KW - AIDS KW - External hemorrhoid KW - Monkeypox KW - Proctitis KW - Rectal pain KW - Tecovirimat JF - Infection JO - Infection N2 - PURPOSE: At the outset of the 2022 human monkeypox virus outbreak, the World Health Organization described the self-limited disease as a rash illness associated with nonspecific symptoms such as fever, myalgias, and lymphadenopathy. Historically, the infection caused by this zoonotic virus has presented with rashes primarily on the face, palms, and soles of feet. However, emerging case report literature from the 2022 recent outbreak highlighted more atypical presentations ranging from ocular manifestations to myocarditis. CASE DESCRIPTION: We present a case of a 32-year-old African American male with a past medical history of poorly controlled acquired immunodeficiency syndrome and external hemorrhoids that presented for worsening rectal pain. The patient was afflicted with diffuse skin lesions even present on his hemorrhoids. Initial imaging significant circumferential rectal thickening consistent with proctitis. Subsequent polymerase chain reaction testing confirmed active monkeypox infection, and a 14-day course of twice daily tecovirimat 600 mg was initiated to treat disseminated monkeypox infection. After improved pain control and starting antiviral treatment, the patient was discharged two days later. CONCLUSION: As more cases of monkeypox-associated proctitis emerge, clinicians should keep this disease in their differential due to the growing atypical presentations that have diverged from previous patterns to avoid the risk of misdiagnosing another sexually transmitted infection. Additionally, appropriate medical management is still not definitive and requires further development of evidence-based protocols to treat such patients. SN - 1439-0973 UR - https://www.unboundmedicine.com/medline/citation/36750482/Monkeypox-induced_proctitis:_a_case_report_of_an_emerging_complication. DB - PRIME DP - Unbound Medicine ER -

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Monkeypox-induced proctitis: a case report of an emerging complication.Infection. 2023 Feb 07 [Online ahead of print]I