Atypical presentation of occupational mpox: a case report from Brazil
Guilherme S. Lira, Mariana Q. S. Melo, Isabela C. Leitão, Matheus V. Andrade, Anna C. Castiñeiras, Diana Mariani, Cássia C. A. Gonçalves, Lendel C. Costa, Danielle A. S. Rodrigues, André M. Vale, Filipe R. R. Moreira, Carolina M. Voloch, Débora S. Faffe, Luiza M. Higa, Rafael M. Galliez, Clarissa R. Damaso, Amilcar Tanuri, Terezinha M. P. P. CastiñeirasABSTRACT
Background
After decades of circulating predominantly in Africa, mpox caused a public health emergency of international concern between 2022 and 2023. Even outside of the epidemic period, the virus still circulates, with threats of reemergence, and different clinical presentations must be brought to attention for optimal surveillance.
Case Summary
We report a case of monkeypox virus (MPXV) infection in a previously healthy physician with an atypical clinical presentation and a single identified exposure. Diagnosis was confirmed by PCR. Viral isolation was employed to reinforce diagnosis. Plaque reduction neutralization assays and semiquantitative ELISA were used to evaluate the antibody response.
Conclusion
Our report has two main messages: atypical symptoms of mpox can hinder diagnosis, making adequate suspicion and testing fundamental; and the risk of occupational exposure must be considered when designing policies for healthcare workers.