Division of Infectious Diseases, Department of Medicine, Stanford University, Palo Alto, California.
Santa Clara Valley Medical Center, Division of Infectious Diseases, AIDS Medicine, Mycobacterial Diseases, and International Health, San Jose, California.
Am J Trop Med Hyg. 2023 Jan 30;108(3):592-594. doi: 10.4269/ajtmh.22-0626. Print 2023 Mar 1.
Mpox (formally monkeypox) is an Orthopoxvirus associated with both zoonotic and person-to-person spread. Human mpox classically presents with rash and systemic symptoms. Although sporadic outbreaks of mpox have occurred worldwide, the 2022 outbreak is the first of pandemic significance. Thousands of geographically dispersed cases were reported beginning in May 2022. The clinical presentations and outcomes of mpox infection have varied greatly based on viral clade. Further guidance is needed for clinicians to diagnose and treat this emerging infection. We present five clinical vignettes of confirmed cases diagnosed in June and July 2022 in northern California to demonstrate the range of mpox disease, including myocarditis, pharyngitis, epididymitis, and proctitis. We note a significant overlap with HIV infection and a high rate of concurrent sexually transmitted infection. Given the heterogenous presentations of mpox disease, clinicians should maintain a high degree of suspicion in patients with oropharyngeal or genital lesions, proctitis, or new rash.
猴痘（原名猴痘病毒）是一种正痘病毒，与动物源和人际传播有关。人类猴痘的典型表现为皮疹和全身症状。尽管世界各地曾零星爆发过猴痘，但 2022 年的疫情是首次具有大流行意义的疫情。自 2022 年 5 月以来，报告了数千例分布在不同地区的病例。根据病毒分支的不同，猴痘感染的临床表现和结果差异很大。临床医生需要更多的指导来诊断和治疗这种新出现的感染。我们介绍了 2022 年 6 月至 7 月在加利福尼亚州北部确诊的五例临床病例，以展示猴痘疾病的范围，包括心肌炎、咽炎、附睾炎和直肠炎。我们注意到与 HIV 感染有显著重叠，且同时并发性传播感染的比例很高。鉴于猴痘疾病的表现多样，临床医生应在有口咽或生殖器损伤、直肠炎或新发皮疹的患者中保持高度怀疑。
