Monkeypox symptoms: from 'canker sore' that isn't thrush to rare necrosis in the nose, here's what we know

Monkeypox symptoms: from ‘canker sore’ that isn’t thrush to rare necrosis in the nose, here’s what we know

The classic photo of skin sores taking over the hands and arms is no yardstick for the current monkeypox epidemic. Health entities such as the US Centers for Disease Control and Prevention (CDC) already point out that other manifestations of the disease are more constant, including the fever and O swollen nodes. When they appear, wounds they can appear in other less visible parts or even in mucous membranes.

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In the case of sores, they can appear on the penis, testicles, lips, vagina or anus, and can also be in other areas.

In addition to the scenario indicated by the US health agency or even the Pan American Health Organization (PAHO), case reports in scientific journals or posts on social networks point to even less common symptoms such as “thrush” (which are actually lesions caused by the virus) or a rare necrosis in the nose

(WARNING: the image of the necrosis case is strong and is at the bottom of this text).

According to the CDC, monkeypox symptoms begin within 3 weeks of exposure to the virus. When it occurs, the rash usually appears up to 4 days later.

Why is the case of necrosis rare?

Researcher Giliane Trindade, virologist, professor and scientist at the Federal University of Minas Gerais (UFMG) explains that the patient with necrosis at the tip of the nose was immunosuppressed: he had a very low TCD4 lymphocyte count, the cell that defends against microorganisms.

a The case of the 40-year-old man was published in the second (15) scientific journal “Infection”, by the Springer Nature group.

“These manifestations of necrosis or other more associated conditions are rarer, but are expected in immunocompromised patients who do not undergo treatment. (…) HIV patients with treatment have presented a better clinical course”, explains Giliane.

STRONG IMAGE: A 40-year-old man with HIV developed necrosis in his nose after being infected with the monkeypox virus – Photo: Infection/Springer Nature/Handout

What are the most common symptoms?

According to Giliane Trindade, the most common symptoms are not always characterized by an external manifestation: it may just be pain in the anal region. In addition, she explains that cases are showing “few lesions and atypical lesions”, often in regions not described in past outbreaks.

“The main symptoms continue to be fever, swelling and the development of lesions, albeit few”, explains the UFMG professor.

According to the virologist, after the incubation period (around 7 days), nonspecific symptoms (fever, prostration, loss of appetite) last for at least 3 to 4 days. It is after this period that the lesions appear. After 3 to 4 weeks, they heal, the scabs come off and a scar forms.

The classic symptoms of the disease are:

  • fever,
  • headache and body aches,
  • back pain,
  • chills,
  • tiredness,
  • skin sores (skin rashes) and
  • swollen nodes (which commonly precede the characteristic rash of the disease)

Classic photo doesn’t sum up

The professor explains that the challenge of the current outbreak is that the manifestations are “very atypical”. “Individuals come [a uma unidade de saúde] with an injury and has no other symptoms. People don’t suspect they have monkeypox,” he says.

The classic photos of the hands of people in the endemic region are no longer what infectologists are seeing, says the professor.

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