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A 40-year-old man presented to the clinic with vesiculopustular lesions on the face, and genital area (A) and two weeks history of fever, sore throat and severe dysphagia. On physical examination, a macular rash, painful lymphadenopathy were observed and multiple 10 mm umbilicated and non-tender lesions on his penis. Due to dysphagia, an endoscopy was performed, showed ulcerated lesions covered by fibrin in the oral cavity and hypopharynx (B), ulcers well defined, less than 1 cm, with normal-appearing intervening mucosa, in the proximal esophagus (C-D). HIV test was positive, syphilis, chlamydia, and gonorrhea were negative. Polymerase-chain-reaction assays of swabs obtained from lesions were positive for monkeypox. Human monkeypox is a zoonosis caused by monkeypox virus, an orthopoxvirus and close relative of variola virus (smallpox) Complications of infection with the monkeypox virus can include respiratory distress, encephalitis, as well as gastrointestinal involvement, which can include vomiting, diarrhea and oral ulcers, proliferative and necrotizing or ulcerative lesions in the esophagus and stomach has been shown in necropsies of animal models. the patient was treated with mouthwash formulations, Proton Pump Inhibitors and clear liquid diet. Gastrointestinal involvement may develop in the early stage of the disease. Hence, diagnostic suspicion is fundamental for early diagnosis and management.
Accepted: January 17, 2023
Received in revised form: November 14, 2022
Received: October 13, 2022
Publication stageIn Press Journal Pre-Proof
Author contributions: The authors contributed equally to writing and revising the manuscript.
Conflict-of-interest statement: The authors have declared no conflicts of interest.
© 2023 by the American Society for Gastrointestinal Endoscopy