Atypical Clinical Presentation of Monkeypox Complicated by Myopericarditis

Darrell H S Tan; Shelby Jaeranny; Maggie Li; Sharon S Sukhdeo; Juan Carlos Monge; Matias F Callejas; Maan Hasso; Ramzi Fattouh; Spencer D Lalonde; Jeffrey Lam; Sharmistha Mishra

doi:10.1093/ofid/ofac394

Atypical Clinical Presentation of Monkeypox Complicated by Myopericarditis

Open Forum Infect Dis. 2022 Aug 3;9(8):ofac394. doi: 10.1093/ofid/ofac394. eCollection 2022 Aug.

Authors

Darrell H S Tan^{1

2

3}, Shelby Jaeranny⁴, Maggie Li⁵, Sharon S Sukhdeo³, Juan Carlos Monge^{3

6}, Matias F Callejas⁷, Maan Hasso⁸, Ramzi Fattouh⁹, Spencer D Lalonde^{3

6}, Jeffrey Lam¹⁰, Sharmistha Mishra^{1

2

3}

Affiliations

¹ Division of Infectious Diseases, St. Michael's Hospital, Toronto, Canada.
² MAP Centre for Urban Health Solutions, St. Michael's Hospital, Toronto, Canada.
³ Department of Medicine, University of Toronto, Toronto, Canada.
⁴ Department of Family and Community Medicine, St. Michael's Hospital, Toronto, Canada.
⁵ Faculty of Medicine, University of Toronto, Toronto, Canada.
⁶ Division of Cardiology, St. Michael's Hospital, Toronto, Canada.
⁷ Department of Medical Imaging, St. Michael's Hospital, Toronto, Canada.
⁸ Public Health Ontario Laboratory, Toronto, Canada.
⁹ Department of Laboratory Medicine, St. Michael's Hospital, Toronto, Canada.
¹⁰ Department of Medicine, Queen's University, Toronto, Canada.

Abstract

We present a case of monkeypox infection in a man presenting with genital and labial ulcers, followed by submandibular lymphadenopathy, fever, and constitutional symptoms. His course was complicated by myopericarditis and an ongoing pleomorphic skin eruption. Viral deoxyribonucleic acid was detected by polymerase chain reaction in skin swabs, nasopharyngeal swab, saliva, and semen.

Keywords: case report; monkeypox; myopericarditis; viral shedding.