尼日利亚一所三级医疗机构中的非典型猴痘病例。

Atypical Mpox in a Nigerian Tertiary Health Facility.

机构信息

Department of Internal Medicine, Alex Ekwueme Federal University Teaching Hospital Abakaliki.

Department of Medicine, University of Nigeria Teaching Hospital, Ituku/Ozalla.

出版信息

J Infect Dis. 2024 Mar 26;229(Supplement_2):S181-S187. doi: 10.1093/infdis/jiad607.

DOI:10.1093/infdis/jiad607

PMID:38157416

Abstract

BACKGROUND

We describe diverse clinical characteristics and course of confirmed mpox cases managed in a Nigerian tertiary health facility.

METHODS

Clinical and epidemiologic data were analyzed, highlighting the unusual presentations of polymerase chain reaction (PCR)-confirmed mpox cases observed during the 2022 outbreak.

RESULTS

Out of 17 suspected cases, 13 (76.4%) were PCR confirmed for mpox. The mean ± SD age for the participants was 28.62 ± 10.29 years (range, 2-55), of which 9 (64.3%) were male. Of the 13 PCR-confirmed cases, 5 (38.5%) had varicella zoster virus coinfection, 2 (15.4%) had HIV coinfection, and 1 (7.7%) had diabetes mellitus comorbidity. All patients experienced rash, with 6 (46.2%) having significant genital lesions and 1 (7.7%) having a severe perianal lesion. A lack of prodromal symptoms was reported in 3 (23.1%), and a prolonged prodrome (>1 week) occurred in 5 (38.5%). Skin lesions were polymorphic in 6 (46.2%), and solitary skin lesions occurred in 3 (23.1%), which persisted for >120 days in 7.7%.

CONCLUSIONS

Clinical recognition, diagnosis, and prevention remain a concern in resource-limited settings. Our findings highlight the need to further evaluate unusual skin lesions and to include mpox screening for genital skin lesions that are presumed to be sexually transmitted infections. Revision of clinical case definition and enhanced surveillance are key to early recognition and prevention of spread.

摘要

背景

我们描述了在尼日利亚一家三级医疗机构中管理的确诊猴痘病例的各种临床特征和病程。

方法

分析了临床和流行病学数据，重点介绍了在 2022 年暴发期间观察到聚合酶链反应（PCR）确诊猴痘病例的不寻常表现。

结果

在 17 例疑似病例中，有 13 例（76.4%）通过 PCR 确认为猴痘。参与者的平均年龄±标准差为 28.62±10.29 岁（范围，2-55 岁），其中 9 例（64.3%）为男性。在 13 例 PCR 确诊病例中，有 5 例（38.5%）合并水痘带状疱疹病毒感染，2 例（15.4%）合并 HIV 感染，1 例（7.7%）合并糖尿病合并症。所有患者均出现皮疹，其中 6 例（46.2%）有明显生殖器损伤，1 例（7.7%）有严重肛周损伤。有 3 例（23.1%）报告无前驱症状，5 例（38.5%）前驱期延长（>1 周）。皮肤损伤呈多形性的有 6 例（46.2%），单发皮肤损伤的有 3 例（23.1%），7.7%的患者皮肤损伤持续>120 天。