Monkeypox Case Studies

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The geographic location of the patient is important in the diagnosis of monkeypox, as the disease usually occurs in remote villages in the tropical African rain forests. Differentiation from chickenpox is important; the latter appears in successive crops so that lesions at various stages of development are visible at any time. In contrast with smallpox, the distribution of chickenpox is 'centripetal' with more lesions on the trunk than on the face and extremities. For definitive diagnosis, scabs can be forwarded to a reference laboratory where electron microscopy may confirm the presence of an orthopoxvirus and differentiate this virus from varicella virus. The virus can be cultured in tissue culture and identified by DNA restriction analysis. …show more content…

A skin biopsy specimen of the vesiculopustular rash or a sample of the roof of an intact vesiculopustule should be analyzed. Tissue for PCR of DNA sequence-specific for the monkeypox virus may be obtained. Paired sera for acute and convalescent titers may be analyzed. Serum collected more than 5 days for IgM detection or serum collected more than 8 days after rash onset for IgG detection was most efficient for the detection of the monkeypox virus infection [26]. A Tzanck smear can help differentiate monkeypox from other nonviral disorders in the differential diagnosis. However, a Tzanck smear does not differentiate a monkeypox infection from smallpox or herpetic infections. Monkey pox cases were confirmed based on virus isolation or detection of the virus by polymerase chain reaction (PCR) from a clinical specimen (skin biopsy or throat culture). Individuals who presented with fever and rash within 21 days of exposure to monkey pox and had serum positive for orthopox immunoglobulin M (IgM), but did not have culture- or PCR- positive clinical specimens, were classified as having a probable case of infection [26, 27]. The most reliable clinical sign differentiating monkeypox from smallpox and chickenpox is enlarged lymph nodes, especially the submental, submandibular, cervical, and inguinal nodes. Regarding exanthema, nonspecific lesions and inflammation of the pharyngeal, conjunctival, and genital mucosae have been observed. 5.1 Histological

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