CDC updates clinical guidance on monkeypox

Clinicians should not rule out monkeypox in patients with rashes considered characteristic of more common infections, such as syphilis, the CDC said in a June 14 health alert update

"The clinical presentation of monkeypox may be similar to some STIs," the update said. "The search for lesions consistent with monkeypox should be performed even if lesions consistent with those from more common infections (e.g., varicella zoster, syphilis, herpes) are observed; this is particularly important when evaluating patients who have epidemiologic risk factors for monkeypox." 

The disease has presented differently in some patients in the U.S. who have contracted it than in Africa, where it is endemic. For example, infected people typically develop a rash after symptoms such as fever, headache, muscle aches and swollen lymph nodes have developed. The rash usually begins on the face or mouth before spreading to other parts of the body, namely lesions on the hands and feet. However, in many of the U.S. cases so far, patients experienced a rash that started around their genitals, anus or mouth. In some cases, other traditional symptoms, including fever and body aches, have not manifested. 

The CDC outlined recommendations for clinicians, including having patients diagnosed with an STI who do not respond to treatment return for a follow-up evaluation and consider monkeypox testing. 

The U.S. had confirmed 84 monkeypox cases across 18 states and Washington, D.C., as of June 15. Globally, more than 2,000 cases have been confirmed. 

To view the full alert, click here

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