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猴痘相关局部并发症的多学科管理:一系列病例报告

Interdisciplinary management of mpox-related local complications: report on a series of cases.

作者信息

Gamo Guerrero María, Simón Gozalbo Ana, Martín Díaz Mariángeles, Díez Madueño Kevin, Del Río Pena Emilio, De la Cueva Pablo, Talaván Tamar, Jiménez Eva, Torres Juan, Valencia Jorge, Cuevas Guillermo, Bibiano Carlos, Ryan Pablo

机构信息

Dermatology Service, Infanta Leonor Hospital, Madrid, Spain.

Faculty of Medicine, Complutense University of Madrid, Madrid, Spain.

出版信息

Front Med (Lausanne). 2023 Jun 1;10:1184924. doi: 10.3389/fmed.2023.1184924. eCollection 2023.

Abstract

Monkeypox (mpox) is a viral zoonosis, and human-to-human transmission can result from close contact with the respiratory secretions and mucocutaneous lesions of an infected person. The prodromal phase is followed by an eruptive phase, with skin and/or mucosal lesions that progress through several stages at different sites. In this study, we describe the importance of interdisciplinary care management and follow-up of patients with complicated mpox. A cross-sectional study was conducted from May 2022 until August 2022 at a secondary hospital in Madrid (Spain). Out of 100 patients with mpox seen at this institution, we selected and analyzed 11 with local complications. All the patients were male at birth, and the mean age was 32 (30-42) years. The clinical manifestations included skin rash or mucosal lesions, fever, myalgia and lymphadenopathies. The most frequent local complications were pharyngitis associated with dysphagia, penile edema, infection of the mucocutaneous lesions, and ulceration of the genital lesions. A multidisciplinary team was created for the care of patients with complications secondary to mpox. The team comprised dermatologists and specialists in infectious diseases, preventive medicine, and emergency medicine. This approach improved the ability to diagnose and treat early with supportive, topical, and systemic treatment. In our center most of the cases were self-limiting, and none were life-threatening. An interdisciplinary response to a public health alert enhances the management of complex patients and should be implemented in successive outbreaks of mpox.

摘要

猴痘是一种病毒性人畜共患病,人与人之间的传播可因与感染者的呼吸道分泌物和皮肤黏膜病变密切接触而发生。前驱期之后是发疹期,会出现皮肤和/或黏膜病变,这些病变会在不同部位经历几个阶段。在本研究中,我们描述了对复杂猴痘患者进行跨学科护理管理和随访的重要性。2022年5月至2022年8月在西班牙马德里的一家二级医院进行了一项横断面研究。在该机构就诊的100例猴痘患者中,我们选择并分析了11例有局部并发症的患者。所有患者出生时均为男性,平均年龄为32(30 - 42)岁。临床表现包括皮疹或黏膜病变、发热、肌痛和淋巴结病。最常见的局部并发症是伴有吞咽困难的咽炎、阴茎水肿、皮肤黏膜病变感染和生殖器病变溃疡。为护理猴痘继发并发症的患者组建了一个多学科团队。该团队由皮肤科医生以及传染病、预防医学和急诊医学专家组成。这种方法提高了通过支持性、局部和全身治疗进行早期诊断和治疗的能力。在我们中心,大多数病例是自限性的,无一例危及生命。对公共卫生警报的跨学科应对可加强对复杂患者的管理,应在猴痘的后续疫情中实施。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c30d/10267306/48520cf0b3a2/fmed-10-1184924-g001.jpg

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