24 июня, 2020

Anorectals and penile swabs best suited for monkeypox diagnosis

Erkenntnis

  • The monkeypox virus (MPXV) may have been transmitted through anal sex, even in male patients presenting without proctitis (rectal pain or discomfort).

Why this matters

  • If MPXV is suspected, take smears of both anorectal lesions and penile lesions, even if there are no rectal symptoms.

Key results

  • Clinical evaluation and anorectal testing averaged 4.6  Days after onset of symptoms:
    • Half (n = 9/18) of the patients had proctitis and 22.2 % (n = 4/18) of the patients had pharyngitis (sore throat with posterior oropharyngeal white plaques).
  • Overall, the anorectal tests of 88.9 % (n = 16/18) of the patients were positive, the anorectal smears were 9 of 9  patients with proctitis and in 7 of 9  Patients without proctitis positive.
    • Of the 9  Men without proctitis had multifocal MPXV DNA-positive skin lesions (including 3 that were completely asymptomatic and 1-_with systemic symptoms [fever, chills, muscle pain and pharyngitis]) according to anorectal samples.
    • The remaining 5  Men had skin lesions on the penis with associated inguinal adenopathy.
  • Half (n = 9/18) of the patients had proctitis and 22.2 % (n = 4/18) of the patients had pharyngitis (sore throat with posterior oropharyngeal white plaques).
  • Of the 9  Men without proctitis had multifocal MPXV DNA-positive skin lesions (including 3 that were completely asymptomatic and 1-_with systemic symptoms [fever, chills, muscle pain and pharyngitis]) according to anorectal samples.
  • The remaining 5  Men had skin lesions on the penis with associated inguinal adenopathy.

Study design

  • Monocentric case series to assess whether clinical anorectal tests in 18 cisgender men having sex with men (mean age: 34.6  years) and with MPXV infection, can improve and facilitate diagnosis
  • Funding: None

Restrictions

  • Viral load could not be determined and viability viral DNA in anorectal samples has not been studied.
  • Small sample

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Source — https://www.univadis.de/viewarticle/anorektale-sowie-penis-abstriche-fur-affenpockendiagnose-am-besten-geeignet

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