背景:MPOX(猴痘)病毒感染,一种以前局限于非洲次大陆的人畜共患疾病,最近,由于城市社区中一种新的“化身”的复兴,引起了全世界的关注。美国皮肤科医生开始看到发烧和自限性脓疱坏死性皮疹的患者,所有其他感染性调查均为阴性。
方法:我们对人口统计学进行了一项前瞻性观察性多中心临床研究,皮肤表现,坏死性脓疱性病变和/或发热患者的结局。
结果:35例PCR证实MPOX病例,主要是外籍人士,进行了随访,发现在疾病发作前1周平均有高风险的异性恋接触。我们发现,在所有情况下,它们都有特征性的环状脓疱性病变,伴有坏死中心或“烟雾环脓疱”。下腹部的病变压痛和好发,耻骨区,并观察到生殖器。大多数病例是系统稳定的,发热平均持续4天,CRP水平升高。生殖器病变容易继发细菌感染。疾病很严重,我们的一名患者发现有较大的环形斑块,患有艾滋病毒。
结论:健康个体的总体预后良好,平均2周内病灶愈合,无疤痕。“新世界MPOX”应从人畜共患病分类为能够在城市人口中传播的性传播感染(STI)。我们的发现有助于初级和二级保健医生早期临床怀疑和与其他STI的区别。
BACKGROUND: MPOX (Monkeypox) viral infection, a zoonotic disease previously confined to the African sub-continent, has caught attention worldwide recently due to its resurgence in a new \'avatar\' among urban communities. Dermatologists in the U. A. E. started to see patients with fever and a self-limiting pustular necrotic rash that was negative for all other infectious investigations.
METHODS: We performed a prospective observational multicenter clinical study of the demographics, skin manifestations, and outcomes of patients presenting with necrotic pustular lesions and/or fever.
RESULTS: 35 cases of PCR confirmed MPOX cases, mostly in the expatriate population, were followed up and found to have high-risk heterosexual contact on an average of 1 week prior to disease onset. We found that they have characteristic annular pustular lesions with necrotic center or \"Smoke ring pustules\' in all cases. Lesion tenderness and predilection for the lower abdomen, pubic area, and genitalia were observed. Most cases were systemically stable, with fever lasting for an average of 4 days and elevated CRP levels. Genital lesions were prone to secondary bacterial infections. The disease was severe, with larger annular plaques in one of our patients found to be living with HIV.
CONCLUSIONS: The overall prognosis in healthy individuals is good, with lesions healing within an average of 2 weeks without scarring. \'New world MPOX\' should be unclassified from zoonosis to a sexually transmitted infection (STI) capable of transmission in an urban population. Our findings can help in early clinical suspicion and differentiation from other STI\'s for primary and secondary health care physicians.