SAUSHEC Emergency Medicine, Brooke Army Medical Center, Fort Sam Houston, San Antonio, TX, United States of America.
Department of Emergency Medicine, University of Texas Southwestern Medical Center, Dallas, TX, United States of America.
Am J Emerg Med. 2022 Nov;61:34-43. doi: 10.1016/j.ajem.2022.08.026. Epub 2022 Aug 20.
Monkeypox is an emerging viral disease that has been declared a global health emergency. While this disease has been present for over 50 years, the recent surge in cases and expanding knowledge of this has prompted a need for a focused review for practicing clinicians.
This narrative review provides a focused overview of the epidemiology, presentation, evaluation, and management of monkeypox for emergency clinicians.
Monkeypox is an orthopoxvirus endemic to central and western Africa. An outbreak in May and June 2022 across Asia, Europe, North America, and South America was declared a global health emergency in July 2022. The disease can be transmitted via contact with an infected animal or human, as well as contact with a contaminated material. The disease presents with a prodromal flu-like illness and lymphadenopathy. A rash spreading in a centrifugal manner involving the oral mucosa, face, palms, and soles is typical. Lesions progress along various stages. Complications such as bacterial skin infection, pneumonitis, ocular conditions, and encephalitis are uncommon. Confirmation typically includes polymerase chain reaction testing. The majority of patients improve with symptomatic therapy, and as of July 2022, there are no United States Food and Drug Administration-approved treatments specifically for monkeypox. However, antiviral treatment should be considered for several patient populations at risk for severe outcomes.
An understanding of the presentation, evaluation, and management of monkeypox is essential for emergency clinicians to ensure appropriate diagnosis and treatment of this emerging disease.
猴痘是一种新兴的病毒性疾病，已被宣布为全球卫生紧急事件。尽管这种疾病已经存在了 50 多年，但最近病例的激增和对这种疾病的认识不断扩大，促使临床医生需要对其进行重点审查。
本叙述性综述为急诊临床医生提供了猴痘的流行病学、表现、评估和管理的重点概述。
猴痘是一种正痘病毒，流行于中非和西非。2022 年 5 月至 6 月，亚洲、欧洲、北美和南美爆发了猴痘疫情，并于 2022 年 7 月宣布为全球卫生紧急事件。该疾病可通过接触受感染的动物或人类以及接触受污染的材料传播。疾病表现为前驱流感样疾病和淋巴结病。典型的皮疹呈离心性扩散，累及口腔黏膜、面部、手掌和脚底。病变沿各个阶段进展。细菌皮肤感染、肺炎、眼部疾病和脑炎等并发症并不常见。通常包括聚合酶链反应检测进行确诊。大多数患者通过对症治疗即可改善，截至 2022 年 7 月，美国食品和药物管理局尚未批准专门用于治疗猴痘的治疗方法。然而，对于有发生严重后果风险的几个患者群体，应考虑使用抗病毒治疗。
了解猴痘的表现、评估和管理对急诊临床医生至关重要，可确保对这种新发疾病进行适当的诊断和治疗。
