Monkeypox causing penile swelling and rectal pain in an ongoing outbreak

To Jason Arunn Murugesu

Swelling of the penis and rectal pain have been reported by some infected people Monkeypox Symptoms that are generally not associated with viral infection during recent outbreaks.

Julia Billinska The Guys and St. Thomas NHS Foundation Trust in London and her colleagues characterized the symptoms of 197 people who tested positive for monkeypox at an infectious disease center in the city between May and July 2022. ..

Of these, 71 reported rectal pain and 31 reported penile swelling. Overall, 20 of the participants were hospitalized for symptom management, 8 of whom were hospitalized for anal or rectal pain and 5 for penile swelling.

All participants had some form of lesion on the skin or mucous membranes that lined the mouth and genitals. Monkeypox is generally associated with a widespread rash, such as chickenpox, which develops into liquid-filled blisters and eventually scabs. However, 22 of the participants had a single lesion.

Nine of the participants also had swelling of the tonsils and another atypical monkeypox symptom.

As of July 28 NHS, Centers for Disease Control and Prevention When World Health Organization We did not recognize rectal pain, swelling of the penis, single lesions or swelling of the tonsils as symptoms of monkeypox.

But on July 25th Great Britain has added one or more lesions to the genitalsA list of monkeypox symptoms in and around the anus, and proctitis – pain or bleeding in the anus or rectum.

Most of the participants (86%) also reported more common monkeypox symptoms such as fever (62%), swollen lymph nodes (58%), myalgia and pain (32%).

According to Billinska, it is unclear why monkeypox is causing new symptoms in some people. “It may indicate a change in the course of the natural illness, or it may be due to the mode of transmission,” she says. “That’s a question that deserves more research.”

It will take some time for new symptoms to be added to the official list, but Billinska says the signs of these infections should not be overlooked. “If you know which signs and symptoms to look for, you can evaluate someone and test them early,” she says.

Of the 197 participants, 70 were HIV positive and 56 had sexually transmitted diseases. “If you have two infections at the same time, it’s very likely that your symptoms will get worse,” says Billinska. “Therefore, if the clinician thinks” this could be monkeypox, “you also need to think about what other screenings can do. [I] What do you do with sexually transmitted diseases? “

The researchers also found that only 26.5% of participants reported close contact with people with monkeypox infection or typical symptoms. “Even if someone doesn’t have the symptoms of monkeypox, it’s definitely more likely that they can tell it,” says Billinska.

She says that those who manifest as asymptomatic infections may have very mild or atypical monkeypox symptoms.

In a study published on July 21, Chloe Orkin Queen Mary University of London and her colleagues also found that 54 of the 528 monkeypox infections diagnosed between April and June in 16 countries had a single genital lesion. I found that.

“Penis, anus, and oral lesions may have occurred at the site of initial contact with the virus due to a sexually transmitted disease or close contact,” she says.

Journal reference: BMJ, DOI: 10.1136 / bmj-2022-072410

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