Infectious and Tropical Diseases Department, Bichat - Claude Bernard Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France.
Infectious and Tropical Diseases Department, Bichat - Claude Bernard Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France.
Clin Microbiol Infect. 2023 Feb;29(2):233-239. doi: 10.1016/j.cmi.2022.08.012. Epub 2022 Aug 23.
A global outbreak of monkeypox virus infections in human beings has been described since April 2022. The objectives of this study were to describe the clinical characteristics and complications of patients with a monkeypox infection.
All consecutive patients with a polymerase chain reaction (PCR)-confirmed monkeypox infection seen in a French referral centre were included.
Between 21 May and 5 July 2022, 264 patients had a PCR-confirmed monkeypox infection. Among them, 262 (262/264, 99%) were men, 245 (245/259, 95%) were men who have sex with men, and 90 (90/216, 42%) practiced chemsex in the last 3 months. Seventy-three (73/256, 29%) patients were living with human immunodeficiency virus infection, and 120 (120/169, 71%) patients were taking pre-exposure prophylaxis against human immunodeficiency virus infection. Overall, 112 (112/236, 47%) patients had contact with a confirmed monkeypox case; it was of sexual nature for 95% of the contacts (86/91). Monkeypox virus PCR was positive on the skin in 252 patients, on the oropharyngeal sample in 150 patients, and on blood in eight patients. The majority of patients presented with fever (171/253, 68%) and adenopathy (174/251, 69%). Skin lesions mostly affected the genital (135/252, 54%) and perianal (100/251, 40%) areas. Overall, 17 (17/264, 6%) patients were hospitalized; none of them were immunocompromised. Complications requiring hospitalization included cellulitis (n = 4), paronychia (n = 3), severe anal and digestive involvement (n = 4), non-cardia angina with dysphagia (n = 4), blepharitis (n = 1), and keratitis (n = 1). Surgical management was required in four patients.
The current outbreak of monkeypox infections has specific characteristics: it occurs in the men who have sex with men community; known contact is mostly sexual; perineal and anal areas are frequently affected; and severe complications include superinfected skin lesions, paronychia, cellulitis, anal and digestive involvement, angina with dysphagia, and ocular involvement.
自 2022 年 4 月以来，已描述了人类中猴痘病毒感染的全球暴发。本研究的目的是描述猴痘感染患者的临床特征和并发症。
纳入了在法国转诊中心进行聚合酶链反应（PCR）确诊的猴痘感染的所有连续患者。
在 2022 年 5 月 21 日至 7 月 5 日期间，有 264 名患者的 PCR 确认猴痘感染。其中，262 名（262/264，99%）为男性，245 名（245/259，95%）为男男性行为者，90 名（90/216，42%）在过去 3 个月内进行过化学性行为。73 名（73/256，29%）患者患有人类免疫缺陷病毒感染，120 名（120/169，71%）患者正在接受人类免疫缺陷病毒感染的暴露前预防。总体而言，112 名（112/236，47%）患者与确诊的猴痘病例有接触；95%的接触是性接触（86/91）。252 名患者的皮肤猴痘病毒 PCR 阳性，150 名患者的口咽样本阳性，8 名患者的血液阳性。大多数患者出现发热（171/253，68%）和腺病（174/251，69%）。皮肤损伤主要影响生殖器（135/252，54%）和肛周（100/251，40%）区域。总体而言，17 名（17/264，6%）患者住院；他们都没有免疫功能低下。需要住院治疗的并发症包括蜂窝织炎（n=4）、甲下脓肿（n=3）、严重肛门和消化道受累（n=4）、非心源性心绞痛伴吞咽困难（n=4）、睑缘炎（n=1）和角膜炎（n=1）。四名患者需要手术治疗。
目前的猴痘感染暴发具有以下特征：发生在男男性行为者人群中；已知接触主要是性接触；会阴和肛门区域经常受到影响；严重的并发症包括感染性皮肤病变、甲下脓肿、蜂窝织炎、肛门和消化道受累、心绞痛伴吞咽困难和眼部受累。
