P039 Adult onset Varicella zoster infection presenting as probable Mpox (Monkeypox)
Published Date: 20th June 2023
Publication Authors: Okecha E, Reddin J, Harrison S, McKiernan J, Bateman A, Fishwick L, Thomson-Glover R
Introduction
A 56 year old cis-male who has sex with men (MSM) presented to our semi-rural Genitourinary Medicine (GUM) service with fever, rigors, arthralgia, lymphadenopathy, headache and rash. He had recently returned from Gran Canaria and was triaged as a probable case of Mpox.
Methods
He had a past medical history of hypercholesterolaemia managed with Atorvastatin; no history of drug or food allergy. He had never been screened for sexually transmitted infections (STIs) and his only sexual contact in the preceding year had been one episode of condomless oral intercourse with a new cis-male partner approximately two weeks before clinic attendance.
Results
Multiple widespread vesicular lesions were noted on his back, chest, torso and limbs; palmar-plantar skin was spared. Right inguinal lymphadenopathy was palpable. Serology was negative for Human Immunodeficiency Virus (HIV), Syphilis, Hepatitis A/C Immunoglobulin G (IgG) and Hepatitis B surface antigen. Chlamydia Trachomatis and Neisseria Gonorrhoeae nucleic acid amplification testing (NAAT) were negative. A viral polymerase chain reaction (PCR) swab of a skin lesion was negative for Mpox but positive for Varicella zoster virus (VZV). Upon further questioning the patient confirmed no history of childhood VZV infection.
Of the 27 patients swabbed for Mpox in 2022 within our service, four (15%) received a positive diagnosis. Of the 23 that were Mpox-PCR negative, two (9%) tested positive for VZV.
Okecha, E; Alabi, M; Reddin, J; Harris, S; McKiernan, J; Bateman, A; Fishwick, L; Thomson-Glover, R.(2023). P039 Adult onset Varicella zoster infection presenting as probable Mpox (Monkeypox). Sexually Transmitted Infections. 99(Suppl 1), pp.A41-A42. [Online]. Available at: https://dx.doi.org/10.1136/sextrans-BASHH-2023.79 [Accessed 3 January 2024]
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