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Monkeypox virus-associated meningoencephalitis diagnosed by detection of intrathecal antibody production. | LitMetric

AI Article Synopsis

  • A 37-year-old previously healthy man developed encephalitis after initially showing mild symptoms of mpox, including skin lesions and genital ulcers.
  • Despite testing negative for the monkeypox virus in his cerebrospinal fluid (CSF), he showed signs of intrathecal antibody production.
  • The case suggests that CNS involvement in mpox may not always lead to severe outcomes and highlights the importance of antibody detection in diagnosis when PCR testing is negative.

Article Abstract

Background: In the 2022 mpox-outbreak most patients presented with mild symptoms. Central nervous system (CNS) involvement has previously been described as a rare and severe complication of mpox; however, diagnostic findings in cerebrospinal fluid (CSF) analysis and neuroimaging studies have only been reported in one case previously.

Case Presentation: We report a previously healthy 37-year-old man with mpox complicated by encephalitis. He first presented with painful skin lesions and genital ulcers; polymerase chain reaction (PCR) from the lesions was positive for mpox. Twelve days later he was admitted with fever and confusion. Neuroimaging and CSF analysis indicated encephalitis. The CSF was PCR-negative for monkeypox virus but intrathecal antibody production was detected. He spontaneously improved over a few days course and recovered fully.

Conclusions: This case of mpox-associated encephalitis shows that CNS involvement in mpox infection may have a relatively mild clinical course, and that detection of intrathecal antibody production can be used to establish the diagnosis if CSF monkeypox virus-PCR is negative.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10792818PMC
http://dx.doi.org/10.1186/s12879-024-09000-0DOI Listing

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