Page 67 - Revista Portuguesa - SPORL - Vol 62. Nº2

Figure 3 examination of the pustule biopsy showed
Vesiculopustular skin lesions on the trunk.
Figure 4
Vesiculopustular skin lesions on the upper limb.
and chlamydia), protein chain reaction (PCR)
and culture of the pustule and oropharyngeal
exudates, and pustule skin biopsy. Of the
diagnostic tests performed, both the pustule
and oropharyngeal exudates PCR tested
positive for MPXV, and the histopathological
findings consistent with infection by this virus.
He remained on contact and droplet isolation
measures and was discharged after tolerating
oral diet on the tenth day of hospitalization.
Discussion
MPXV is not new, since African nations
have been dealing with outbreaks of the
virus for a long time. Although considered
peculiar and atypical, oral and pharyngeal
manifestations of this monkeypox outbreak
may have a prevalence of around 36% of all
infections5, which is why clinical assessment
for patients with monkeypox or in high-risk
locations for monkeypox should include
oropharyngeal examination. Among these
oropharyngeal manifestations, we highlight
the most common: pharyngitis, tonsillitis,
tonsillar abscesses, and ulcerated lesions
of the oral mucosa that may evolve from
vesicles to pustules. The oropharyngeal
manifestations may be misdiagnosed as
bacterial infections or confused with another
STI, so the otolaryngologist should be alert
to this pathology. The management of
this infection doesn't rely on medications
designed specifically for MPXV. The majority of
the patients with mild symptoms recover only
with supportive measures such as analgesia
and hydration. Drugs that inhibit viral DNA
synthesis can be employed in severe cases.
Evidence indicates that receiving the smallpox
vaccine in the past could provide protection
against the monkeypox virus and potentially
enhance the clinical symptoms during an
infection .
6
In conclusion, oral and oropharyngeal
manifestations of MPXV in this outbreak
period can become more prevalent, which is
why oropharyngeal examination should be
part of the clinical assessment for patients
with monkeypox. Nonetheless, every at-risk
individual exhibiting oral and oropharyngeal
symptoms suggestive of STIs ought to get a
test for MPXV infection.
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