Atypical Mpox in a Nigerian Tertiary Health Facility

Abstract

Abstract Background We describe diverse clinical characteristics and course of confirmed Mpox cases managed in a Nigerian tertiary health facility. Method Clinical and epidemiological data were analyzed highlighting the unusual presentations of PCR confirmed Mpox cases observed during 2022 outbreak. Result Out of 17 suspected cases, 13(76.4%) were PCR confirmed for Mpox. The mean age for the participants was 28.62 ±10.29 (2-55) years of which 9(64.3%) were males. Of the thirteen PCR confirmed cases, 5(38.5%) had VZV co-infection, 2(15.4%) HIV co-infection and 1(7.7%) Diabetes Mellitus co-morbidity. All the patients experienced rash with 6(46.2%) having significant genital lesions and severe perianal lesion in 1(7.7%). Lack of prodromal symptom were reported in 3(23.1%) and prolonged prodrome >1week in 5(38.5%). Skin lesions were polymorphic in 6(46.2%) with solitary skin lesions in 3(23.1%) and persisted for >120 days in 7.7%. Conclusion Clinical recognition, diagnosis, and prevention still remain a concern in resource-limited settings. Our findings highlight the need for further evaluation of unusual skin lesions and inclusion of mpox screening for genital skin lesions presumed STI. Revision of clinical case definition and enhanced surveillance is key to early recognition and prevention of spread.