DOI: https://doi.org/10.14710/dmj.v13i5.42539

Oral and Perioral Manifestations in Monkeypox Patients: A Systematic Review of Case Reports and Case Series

*Fiki Muhammad Ridho orcid  -  Faculty of Dental Medicine, Universitas Airlangga, Surabaya, Indonesia, Indonesia
Mohammad Iqbal orcid  -  Faculty of Dental Medicine, Universitas Airlangga, Surabaya, Indonesia, Indonesia
Eko Puji Laksono orcid  -  Tarakan General Hospital, Jakarta, Indonesia, Indonesia
Rafael Sena Saraiva Leal  -  School of Health Sciences, Universidade Salvador, Salvador, Brazil, Brazil

Citation Format:
Abstract

Background: Human monkeypox (MPX) is an infectious disease caused by the MPX virus. One of the manifestations caused by MPX in humans is lesions in the oral cavity and surrounding areas. This is of particular concern, especially for dentists, when identifying MPX through oral and perioral inspection. Objective: This study aims to systematically and comprehensively describe MPX patients' oral and perioral manifestations. Methods: Adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a systematic literature search was conducted on the following databases: PubMed, ScienceDirect, Scopus, Wiley, and Google Scholar. Quality assessment was performed using the JBI critical appraisal checklist. Results: 824 articles were identified from the databases and 45 case report studies and 3 case series studies involving 57 MPX patients with oral and perioral manifestations were eligible for review. All included articles were rated moderate to high quality based on the quality assessment. According to the pooled data obtained, the most common prevalence of oral and perioral manifestations is ulcers (19.3%), followed by sore throat (18.6%), edema (10.7%), pustules (10%), erythema (7.9%), and vesicles (5.7%). Based on the location of oral and perioral lesions, the most common occurred in the oropharynx and pharynx (27.5%), perioral (17.4%), tongue (12.8%), tonsils (12.8%), and lips (10.1%). Conclusion: The most common oral and perioral manifestations in MPX patients are ulcers, sore throat, edema, pustules, erythema, and vesicles which can be found most often in the oropharynx/pharynx, perioral, tongue, tonsil and lip region.

Fulltext View|Download
Keywords: monkeypox; monkeypox disease; MPX; oral; oropharynx; perioral

Article Metrics:

Article Info
Section: Original Articles
Language : EN
Recent articles
Oral and Perioral Manifestations in Monkeypox Patients: A Systematic Review of Case Reports and Case Series The Correlation between Duration and Frequency of Writing Activities on Subjective Complaints of Carpal Tunnel Syndrome Relationship Between Fasting Blood Glucose Levels and Lipid Profiles in Type 2 Diabetes Mellitus Patients with Hypertension The Art of Anti-Snake Venom Administration in Snakebite Grade III Following Viper Snakebite in Developing Country: A Case Report Scurvy with Musculoskeletal Pain in Indonesian Pediatric Patient: A Case Report Identifying Acute Ischemic Stroke with Hemichorea as A Clinical Manifestation: A Case Report More recent articles
  1. McCollum AM, Damon IK. Human Monkeypox. Clinical Infectious Diseases. 2014 Jan 15;58(2):260–7. https://doi.org/10.1093/cid/cit703
  2. Ferdous J, Barek MdA, Hossen MdS, Bhowmik KK, Islam MS. A review on monkeypox virus outbreak: New challenge for world. Health Science Reports. 2023 Jan 25;6(1). https://doi.org/10.1002/hsr2.1007
  3. Niu L, Liang D, Ling Q, Zhang J, Li Z, Zhang D, et al. Insights into monkeypox pathophysiology, global prevalence, clinical manifestation and treatments. Frontiers in Immunology. 2023 Mar 21;14. https://doi.org/10.3389/fimmu.2023.1132250
  4. Islam MdA, Ahammed T, Noor STA, Hasan MN, Hoque MN, Tiwari A, et al. An Estimation of Five-decade Long Monkeypox Case Fatality Rate: Systematic Review and Meta-analysis. Journal of Pure and Applied Microbiology. 2022 Dec 30;16(suppl 1):3036–47. https://doi.org/10.22207/JPAM.16.SPL1.16
  5. World Health Organization. Multi-country outbreak of monkeypox, External situation report #2 - 25 July 2022 [Internet]. 2022 [cited 2023 Jul 8]. Available from: https://www.who.int/publications/m/item/multi-country-outbreak-of-monkeypox--external-situation-report--2---25-july-2022
  6. World Health Organization. Second meeting of the International Health Regulations (2005) (IHR) Emergency Committee regarding the multi-country outbreak of monkeypox [Internet]. 2022 [cited 2023 Jul 8]. Available from: https://www.who.int/news/item/23-07-2022-second-meeting-of-the-international-health-regulations-(2005)-(ihr)-emergency-committee-regarding-the-multi-country-outbreak-of-monkeypox
  7. Minhaj FS, Ogale YP, Whitehill F, Schultz J, Foote M, Davidson W, et al. Monkeypox Outbreak — Nine States, May 2022. MMWR Morbidity and Mortality Weekly Report. 2022 Jun 10;71(23):764–9. https://doi.org/10.15585/mmwr.mm7123e1
  8. Russo AT, Grosenbach DW, Chinsangaram J, Honeychurch KM, Long PG, Lovejoy C, et al. An overview of tecovirimat for smallpox treatment and expanded anti-orthopoxvirus applications. Expert Review of Anti-infective Therapy. 2021 Mar 4;19(3):331–44. https://doi.org/10.1080/14787210.2020.1819791
  9. Thakur M, Das P, Sobti RC, Kaur T. Human monkeypox: epidemiology, transmission, pathogenesis, immunology, diagnosis and therapeutics. Molecular and Cellular Biochemistry. 2023 Sep 10;478(9):2097–110. https://doi.org/10.1007/s11010-022-04657-0
  10. Ahmed M, Naseer H, Arshad M, Ahmad A. Monkeypox in 2022: A new threat in developing. Annals of Medicine & Surgery. 2022 Jun;78. https://doi.org/10.1016/j.amsu.2022.103975
  11. Antinori A, Mazzotta V, Vita S, Carletti F, Tacconi D, Lapini LE, et al. Epidemiological, clinical and virological characteristics of four cases of monkeypox support transmission through sexual contact, Italy, May 2022. Eurosurveillance. 2022 Jun 2;27(22). https://doi.org/10.2807/1560-7917.ES.2022.27.22.2200421
  12. Sah R, Abdelaal A, Reda A, Katamesh BE, Manirambona E, Abdelmonem H, et al. Monkeypox and Its Possible Sexual Transmission: Where Are We Now with Its Evidence? Pathogens. 2022 Aug 17;11(8):924. https://doi.org/10.3390/pathogens11080924
  13. Kaler J, Hussain A, Flores G, Kheiri S, Desrosiers D. Monkeypox: A Comprehensive Review of Transmission, Pathogenesis, and Manifestation. Cureus. 2022 Jul 3;14(7):e26531. https://doi.org/10.7759/cureus.26531
  14. Thornhill JP, Barkati S, Walmsley S, Rockstroh J, Antinori A, Harrison LB, et al. Monkeypox Virus Infection in Humans across 16 Countries — April–June 2022. New England Journal of Medicine. 2022 Aug 25;387(8):679–91. https://doi.org/10.1056/NEJMoa2207323
  15. Adler H, Gould S, Hine P, Snell LB, Wong W, Houlihan CF, et al. Clinical features and management of human monkeypox: a retrospective observational study in the UK. The Lancet Infectious Diseases. 2022 Aug;22(8):1153–62. https://doi.org/10.1016/S1473-3099(22)00228-6
  16. de Sousa D, Frade J, Patrocínio J, Borges-Costa J, Filipe P. Monkeypox infection and bacterial cellulitis: a complication to look for. International Journal of Infectious Diseases. 2022 Oct;123:180–2. https://doi.org/10.1016/j.ijid.2022.08.024
  17. Rampogu S, Kim Y, Kim SW, Lee KW. An overview on monkeypox virus: Pathogenesis, transmission, host interaction and therapeutics. Frontiers in Cellular and Infection Microbiology. 2023 Feb 10;13. https://doi.org/10.3389/fcimb.2023.1076251
  18. Ajmera KM, Goyal L, Pandit T, Pandit R. Monkeypox – An emerging pandemic. IDCases. 2022;29:e01587. https://doi.org/10.1016/j.idcr.2022.e01587
  19. Akpoigbe K, Yannick J, Culpepper-Morgan J. Near obstructing painful anorectal mass and facial rash in a man with monkeypox: A case report. World Journal of Clinical Cases. 2023 Oct 26;11(30):7418–23. https://doi.org/10.12998/wjcc.v11.i30.7418
  20. Alsalihi Y, Aradhyula LY, Teitelbaum B. Delayed Presentation of Acute Tonsillitis Due to Monkeypox in an Immunocompromised Patient: Unique Cause of a Common Disease. Cureus. 2023 Aug 22;15(8). https://doi.org/10.7759/cureus.43930
  21. Anderson MG, Frenkel LD, Homann S, Guffey J. A case of severe monkeypox virus disease in an American child: emerging infections and changing professional values. The Pediatric Infectious Disease Journal. 2003 Dec;22(12):1093–6. https://doi.org/10.1097/01.inf.0000101821.61387.a5
  22. Ashish S, Patterson R, Tomsey AK. Non-painful, Non-itchy Monkeypox Virus Rash: A Case Report. Cureus. 2022 Dec 9;14(12):e32342. https://doi.org/10.7759/cureus.32342
  23. Attieh RM, Brumble L, Elwasila SM, Wadei HM. Disseminated Monkeypox Infection in a Kidney Transplant Recipient: A Case Report. Transplantation Proceedings. 2023 Apr;55(3):667–71. https://doi.org/10.1016/j.transproceed.2023.02.031
  24. Bakshi D, Rapose A, Nandagopal D, Vyas S. Severe Monkeypox Infection in a Patient with AIDS: An Illustrative Case Report. Advances in Infectious Diseases. 2023;13(02):323–32. https://doi.org/10.4236/aid.2023.132029
  25. Bartholomew E, Kosche C, Leslie KS. Mpox infection presenting with morbilliform rash: A case series. JAAD Case Reports. 2023 May;35:98–102. https://doi.org/10.1016/j.jdcr.2023.03.001
  26. Costello V, Sowash M, Gaur A, Cardis M, Pasieka H, Wortmann G, et al. Imported Monkeypox from International Traveler, Maryland, USA, 2021. Emerging infectious diseases. 2022 May;28(5):1002–5. https://doi.org/10.3201/eid2805.220292
  27. Hussein MH, Mohamad MA, Dhakal S, Sharma M. Cellulitis or Lymphadenopathy: A Challenging Monkeypox Virus Infection Case. Cureus. 2023 Jun 5;15(6):e40008. https://doi.org/10.7759/cureus.40008
  28. Jang W, Kandimalla L, Rajan S, Abreu R, Campos JE. Monkeypox in an immunocompromised patient with underlying human immunodeficiency virus and syphilis infections in Southern Florida of the United States: a case report. AIDS Research and Therapy. 2023 Feb 18;20(1):12. https://doi.org/10.1186/s12981-023-00504-4
  29. Manoharan A, Braz BX, McBride A, Hernandez S, Balfour M, Quiroz T, et al. Severe monkeypox with superimposed bacterial infection in an immunocompetent patient: A case report. IDCases. 2022;30:e01626. https://doi.org/10.1016/j.idcr.2022.e01626
  30. Ortiz-Martínez Y, Rodríguez-Morales AJ, Franco-Paredes C, Chastain DB, Gharamti AA, Vargas Barahona L, et al. Monkeypox – a description of the clinical progression of skin lesions: a case report from Colorado, USA. Therapeutic Advances in Infectious Disease. 2022 Jan 27;9:204993612211177. https://doi.org/10.1177/20499361221117726
  31. Perzia B, Theotoka D, Li K, Moss E, Matesva M, Gill M, et al. Treatment of ocular-involving monkeypox virus with topical trifluridine and oral tecovirimat in the 2022 monkeypox virus outbreak. American Journal of Ophthalmology Case Reports. 2023 Mar;29:101779. https://doi.org/10.1016/j.ajoc.2022.101779
  32. Peters SM, Hill NB, Halepas S. Oral Manifestations of Monkeypox: A Report of 2 Cases. Journal of Oral and Maxillofacial Surgery. 2022 Nov;80(11):1836–40. https://doi.org/10.1016/j.joms.2022.07.147
  33. Sejvar JJ, Chowdary Y, Schomogyi M, Stevens J, Patel J, Karem K, et al. Human monkeypox infection: a family cluster in the midwestern United States. The Journal of infectious diseases. 2004 Nov 15;190(10):1833–40. https://doi.org/10.1086/425039
  34. Smith K, Tyson K, Hossain R, Young A, Melnick J. Progressively confluent monkeypox lesions with necrosis. Oxford Medical Case Reports. 2023 Jan 1;2023(1). https://doi.org/10.1093/omcr/omac153
  35. Studemeister L, Pai S, Walsh K, Cooper J. Acute Tonsillitis Due To Monkeypox. The Journal of Emergency Medicine. 2023 Feb;64(2):211–3. https://doi.org/10.1016/j.jemermed.2022.12.029
  36. Sturgis MR, Mossack SM, Feng CL, Roadman DF, Salkowski ME, Olweny EO. Genital monkeypox superimposed on co-incident sexually transmitted infections in AIDS patient; a case report. Urology Case Reports. 2022 Nov;45:102238. https://doi.org/10.1016/j.eucr.2022.102238
  37. Wong L, Gonzales-Zamora JA, Beauchamps L, Henry Z, Lichtenberger P. Clinical presentation of Monkeypox among people living with HIV in South Florida: a case series. Le infezioni in medicina. 2022;30(4):610–8. https://doi.org/10.53854/liim-3004-17
  38. Eltvedt AK, Christiansen M, Poulsen A. A Case Report of Monkeypox in a 4-Year-Old Boy from the DR Congo: Challenges of Diagnosis and Management. Case Reports in Pediatrics. 2020 Apr 9;2020:1–4. https://doi.org/10.1155/2020/8572596
  39. Fischer F, Mehrl A, Kandulski M, Schlosser S, Müller M, Schmid S. Monkeypox in a Patient with Controlled HIV Infection Initially Presenting with Fever, Painful Pharyngitis, and Tonsillitis. Medicina. 2022 Oct 7;58(10):1409. https://doi.org/10.3390/medicina58101409
  40. Noe S, Zange S, Seilmaier M, Antwerpen MH, Fenzl T, Schneider J, et al. Clinical and virological features of first human monkeypox cases in Germany. Infection. 2023 Feb 11;51(1):265–70. https://doi.org/10.1007/s15010-022-01874-z
  41. Jang YR, Lee M, Shin H, Kim JW, Choi M min, Kim YM, et al. The First Case of Monkeypox in the Republic of Korea. Journal of Korean Medical Science. 2022;37(27). https://doi.org/10.3346/jkms.2022.37.e224
  42. Ambrogio F, Laface C, De Caro AP, Loconsole D, Centrone F, Lettini T, et al. Peri-oral Monkeypox Virus Infection: A Clinical Report with Confirmatory Polymerase Chain Reaction Findings. Vaccines. 2022 Dec 23;11(1):36. https://doi.org/10.3390/vaccines11010036
  43. Baldovin T, Girolametto G, Geppini R, Bordignon M, Alaibac M. Preventing and fighting stigma: a lesson from the first Mpox in Veneto region of Northeast Italy—A case report. Frontiers in Public Health. 2023 May 19;11. https://doi.org/10.3389/fpubh.2023.1141742
  44. Mileto D, Riva A, Cutrera M, Moschese D, Mancon A, Meroni L, et al. New challenges in human monkeypox outside Africa: A review and case report from Italy. Travel Medicine and Infectious Disease. 2022 Sep;49:102386. https://doi.org/10.1016/j.tmaid.2022.102386
  45. Nolasco S, Vitale F, Geremia A, Tramuto F, Maida CM, Sciuto A, et al. First case of monkeypox virus, SARS-CoV-2 and HIV co-infection. Journal of Infection. 2023 Jan;86(1):e21–3. https://doi.org/10.1016/j.jinf.2022.08.014
  46. Bížová B, Veselý D, Trojánek M, Rob F. Coinfection of syphilis and monkeypox in HIV positive man in Prague, Czech Republic. Travel Medicine and Infectious Disease. 2022 Sep;49:102368. https://doi.org/10.1016/j.tmaid.2022.102368
  47. Baudouin R, Vallée A, Zucman D, Hans S. Detection of Monkeypox Virus in 2 Cases of Oral Sexually Transmitted Infection. Ear, Nose & Throat Journal. 2023 May 15;014556132311757. https://doi.org/10.1177/01455613231175786
  48. Davido B, D’Anglejan E, Baudoin R, Dahmane L, Chaud A, Cortier M, et al. Monkeypox outbreak 2022: an unusual case of peritonsillar abscess in a person previously vaccinated against smallpox. Journal of Travel Medicine. 2022 Sep 17;29(6):taac082. https://doi.org/10.1093/jtm/taac082
  49. Frade JV, Sousa I, Marques T, Filipe P. Acute paronychia: An atypical presentation of Monkeypox infection. Enfermedades infecciosas y microbiologia clinica (English ed). 2023 May;41(5):317–8. https://doi.org/10.1016/j.eimce.2022.09.011
  50. Martín Fernandes A, Sá Breda M, Rios G, Dias L. Oropharyngeal manifestations of monkeypox – Case report. Portuguese Journal of Otorhinolaryngology and Head and Neck Surgery. 2024 Jun 4;171-174 Pages. https://doi.org/10.34631/SPORL.2134
  51. Jarman EL, Alain M, Conroy N, Omam LA. A case report of monkeypox as a result of conflict in the context of a measles campaign. Public Health in Practice. 2022 Dec;4:100312. https://doi.org/10.1016/j.puhip.2022.100312
  52. Lima EL de, Barra LAC, Borges LMS, Medeiros LA, Tomishige MYS, Santos L de SLA, et al. First case report of monkeypox in Brazil: clinical manifestations and differential diagnosis with sexually transmitted infections. Revista do Instituto de Medicina Tropical de São Paulo. 2022;64:e54. https://doi.org/10.1590/S1678-9946202264054
  53. Lopes PS, Haddad GR, Miot HA. Sexually-transmitted monkeypox: report of two cases. Anais Brasileiros de Dermatologia. 2022 Nov;97(6):783–5. https://doi.org/10.1016/j.abd.2022.08.002
  54. Raffaele RM, Baldo ME, Santana GU, da Costa GP, Palma LF, Campos L. Phototherapies for the management of a large painful facial cutaneous lesion from human monkeypox infection. Photodiagnosis and Photodynamic Therapy. 2023 Mar;41:103276. https://doi.org/10.1016/j.pdpdt.2023.103276
  55. Lucar J, Roberts A, Saardi KM, Yee R, Siegel MO, Palmore TN. Monkeypox Virus–Associated Severe Proctitis Treated With Oral Tecovirimat: A Report of Two Cases. Annals of Internal Medicine. 2022 Nov;175(11):1626–7. https://doi.org/10.7326/L22-0300
  56. Mathieson T, Dulguerov N, Mermod M. Monkeypox mucosal lesions. IDCases. 2022;29:e01600. https://doi.org/10.1016/j.idcr.2022.e01600
  57. Oprea C, Ianache I, Piscu S, Tardei G, Nica M, Ceausu E, et al. First report of monkeypox in a patient living with HIV from Romania. Travel Medicine and Infectious Disease. 2022 Sep;49:102395. https://doi.org/10.1016/j.tmaid.2022.102395
  58. Rodríguez A, Rodríguez LC, Bastidas N. Acute disseminated encephalomyelitis in a patient with monkeypox: a case report and radiological findings. Emergency Radiology. 2022 Dec 8;30(1):127–31. https://doi.org/10.1007/s10140-022-02108-3
  59. Yadav PD, Reghukumar A, Sahay RR, K S, Shete AM, Raman A, et al. First two cases of Monkeypox virus infection in travellers returned from UAE to India, July 2022. Journal of Infection. 2022 Nov;85(5):e145–8. https://doi.org/10.1016/j.jinf.2022.08.007
  60. Alsarhani WK, Chan CC, Boyd SR, Hasso M, Almeer A, Tan DHS. Monkeypox-Associated Disciform Keratitis. Cornea. 2023 May;42(5):641–4. https://doi.org/10.1097/ICO.0000000000003171
  61. Amos D, Collins J, Walker DT. Monkeypox presenting as supraglottitis in an immunocompromised patient. BMJ Case Reports. 2023 Feb 3;16(2):e252213. https://doi.org/10.1136/bcr-2022-252213
  62. Campos LAP, Rodriguez WAH, Ruiz ESB, Muñoz ISM, Jaimes AM. Severe Monkeypox Virus Associated with HIV, Hepatitis C Virus and Ulcerative Colitis: A Case Report and Literature Review. South Asian Research Journal of Medical Sciences. 2023 Aug 26;5(04):120–5. https://doi.org/10.36346/sarjms.2023.v05i04.005
  63. Sanromán Guerrero MA, Sánchez EH, Ruanes B de N, Fernández-González P, Ugalde SA, Leal AG, et al. Case report: From monkeypox pharyngitis to myopericarditis and atypical skin lesions. Frontiers in Cardiovascular Medicine. 2023 Jan 5;9. https://doi.org/10.3389/fcvm.2022.1046498
  64. Chen C, Yao W, Huang S, Peng L, Feng S, Wu W, et al. Successful treatment of severe monkeypox case with advanced HIV infection using plasma from smallpox‐vaccinated healthy population: A case report. iLABMED. 2024 Mar;2(1):60–6. https://doi.org/10.1002/ila2.32
  65. Pisano L, Turco M, Mancuso FR, Lastrucci I, Pimpinelli N. Atypical oral presentation of monkeypox virus: A report of two cases from Florence, Italy. Travel Medicine and Infectious Disease. 2022 Nov;50:102457. https://doi.org/10.1016/j.tmaid.2022.102457
  66. Bagde H, Dhopte A, Bukhary F, Momenah N, Akhter F, Mahmoud O, et al. Monkeypox and oral lesions associated with its occurrence: a systematic review and meta-analysis. F1000Research. 2023 Aug 10;12:964. https://doi.org/10.12688/f1000research.137363.1
  67. Samaranayake L, Anil S. The Monkeypox Outbreak and Implications for Dental Practice. International Dental Journal. 2022 Oct;72(5):589–96. https://doi.org/10.1016/j.identj.2022.07.006
  68. MacLachlan N, Dubovi E. Pathogenesis of Viral Infections and Diseases. In: Fenner’s Veterinary Virology [Internet]. Elsevier; 2017. p. 47–78. https://doi.org/10.1016/B978-0-12-800946-8.00003-9
  69. Farahat RA, Sah R, El-Sakka AA, Benmelouka AY, Kundu M, Labieb F, et al. Human monkeypox disease (MPX). Infez Med. 2022;30(3):372–91. https://doi.org/10.53854/liim-3003-6
  70. Ruiz-Mojica CA, Brizuela M. Viral Infections of the Oral Mucosa. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023. Available from: http://www.ncbi.nlm.nih.gov/books/NBK585132/
  71. Zemouri C, Beltrán EO, Holliday R, Jakubovics NS, Allison JR. Monkeypox: what do dental professionals need to know? British Dental Journal. 2022 Oct 14;233(7):569–74. https://doi.org/10.1038/s41415-022-5079-8
  72. Issa AW, Alkhofash NF, Gopinath D, Varma SR. Oral Manifestations in Monkeypox: A Scoping Review on Implications for Oral Health. Dentistry Journal. 2023 May 12;11(5):132. https://doi.org/10.3390/dj11050132
  73. Joseph B, Anil S. Oral lesions in human monkeypox disease and their management—a scoping review. Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology. 2023 Apr;135(4):510–7. https://doi.org/10.1016/j.oooo.2022.11.012
  74. Jaiswal V, Nain P, Mukherjee D, Joshi A, Savaliya M, Ishak A, et al. Symptomatology, prognosis, and clinical findings of Monkeypox infected patients during COVID‐19 era: A systematic‐review. Immunity, Inflammation and Disease. 2022 Nov 11;10(11). https://doi.org/10.1002/iid3.722
  75. Ogoina D, Izibewule JH, Ogunleye A, Ederiane E, Anebonam U, Neni A, et al. The 2017 human monkeypox outbreak in Nigeria—Report of outbreak experience and response in the Niger Delta University Teaching Hospital, Bayelsa State, Nigeria. PLOS ONE. 2019 Apr 17;14(4):e0214229. https://doi.org/10.1371/journal.pone.0214229
  76. Gandhi P A, Patro SK, Sandeep M, Satapathy P, Shamim MA, Kumar V, et al. Oral manifestation of the monkeypox virus: a systematic review and meta-analysis. eClinicalMedicine. 2023 Feb;56:101817. https://doi.org/10.1016/j.eclinm.2022.101817
  77. Philpott D, Hughes CM, Alroy KA, Kerins JL, Pavlick J, Asbel L, et al. Epidemiologic and Clinical Characteristics of Monkeypox Cases — United States, May 17–July 22, 2022. MMWR Morbidity and Mortality Weekly Report. 2022 Aug 12;71(32):1018–22. https://doi.org/10.15585/mmwr.mm7132e3
  78. Liu Q, Fu L, Wang B, Sun Y, Wu X, Peng X, et al. Clinical Characteristics of Human Mpox (Monkeypox) in 2022: A Systematic Review and Meta-Analysis. Pathogens. 2023 Jan 15;12(1):146. https://doi.org/10.3390/pathogens12010146
  79. Tarín-Vicente EJ, Alemany A, Agud-Dios M, Ubals M, Suñer C, Antón A, et al. Clinical presentation and virological assessment of confirmed human monkeypox virus cases in Spain: a prospective observational cohort study. The Lancet. 2022 Aug;400(10353):661–9. https://doi.org/10.1016/S0140-6736(22)01436-2
  80. Grau Echevarría A, Peñuelas Leal R, Martínez Domenech Á, Labrandero Hoyos C, Lorca Spröhnle J, Casanova Esquembre A, et al. Clinical and Demographic Features of 49 Patients With Human Monkeypox Virus–Confirmed Infection in a Tertiary Care Center in Valencia, Spain: A Descriptive Study. Sexually Transmitted Diseases. 2023 Feb;50(2):66–73. https://doi.org/10.1097/OLQ.0000000000001734
  81. Prasad S, Galvan Casas C, Strahan AG, Fuller LC, Peebles K, Carugno A, et al. A dermatologic assessment of 101 mpox (monkeypox) cases from 13 countries during the 2022 outbreak: Skin lesion morphology, clinical course, and scarring. Journal of the American Academy of Dermatology. 2023 May;88(5):1066–73. https://doi.org/10.1016/j.jaad.2022.12.035

Last update:

No citation recorded.

Last update:

No citation recorded.