Bonn case report: Doctors describe early symptoms of monkeypox

Bonn case report
Doctors describe an early symptom of monkeypox

With currently 1790 reported cases, Germany is a monkeypox hotspot. In order to stop the spread of the virus, it is necessary to diagnose and treat the infection quickly. A possible early sign of the disease is now presented.

In the early stages, monkeypox infection is difficult to diagnose. Moreover, the incubation period is between 5 and 21 days. Doctors at the University Hospital Bonn therefore report a case which indicates an early symptom of a monkeypox virus infection. In “Deutsches Ärzteblatt”, Stefan Schlabe and Christoph Boesecke present the medical history of a patient who initially presented to the GP with a new blister in the corner of his mouth. The 51-year-old man is an HIV-positive patient who has adapted well to antiretroviral therapy for years.

The man, who otherwise showed no other signs of illness, was first prescribed an ointment and sent home. But it did not help, and a few days later the blisters turned into a so-called corner of the mouth ulcer, that is, a painful ulcer in the corner of the mouth. The patient therefore returned to his family doctor, who took a smear from the ulcer and sent it to a laboratory for examination. There, monkeypox viruses were detected using the polymerase chain reaction (PCR).

Four days of hospital treatment

The infected patient then developed other symptoms. The typical monkeypox blisters formed on the skin and in the mouth. The blisters continued to increase in the palate area. The blisters became so numerous that the base of the tongue swelled up and the patient could no longer speak properly. He then had to be admitted to the University Hospital in Bonn, where antiviral treatment was also started. As a result, the man recovered quickly and was discharged from hospital after just four days.

The first case of monkeypox infection in Germany was discovered on May 19, 2022. According to the report, the Robert Koch Institute currently records 1,790 confirmed monkeypox infections in the country. The World Health Organization has counted more than 6,000 cases so far. The publication of the case aims to sensitize doctors to consider infection with monkeypox viruses as soon as possible in the future in case of ulcers at the corners of the mouth. Patients could also benefit from this knowledge.

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