German scientists provided a case study of a 51-year-old patient that highlighted one of the first symptoms a monkeypox-infected person might notice: an ulcer at the corner of the mouth. The case study, published in Deutsches Aerzteblatt International, included an image of the aforementioned mouth ulcer and elaborates on details about the monkeypox virus detection process.
A rash on the face, body and genitals are usual signs of monkeypox infection, but symptoms can include internal mouth lesions, outbreaks on the lips, and ulcers like this one in the corner of the mouth. Symptoms also include fever, headache, and fatigue.
The case study features a HIV-positive patient who sought diagnosis and treatment from his general practitioner after developing a vesicle at the left corner of the mouth. He had been successfully managing his health with antiretroviral therapy. Soon after confirming the ulcer was caused by monkeypox using a swab test, the patient experienced an increase in monkeypox vesicles on the skin and roof of the mouth. The base of the patient’s tongue swelled to the point of interfering with his speech. At this point the patient was admitted to the hospital and administered antiviral treatment with tecovirimat.
A recent review published in the Journal of Oral Pathology and Medicine highlighted how most monkeypox-related oral lesions develop in different parts of the oral mucosa, but they are mainly in the tonsils manifested as papules, vesicles, pustules, and ulcers.
This review involved an initial electronic exploration of 19 publications that included analysis of 1,256 patients with monkeypox. The study population consisted mostly of adults and a few infected children, and they reported oral lesions manifested as papules, vesicles, pustules, and ulcers in various parts of the oral mucosa, with most concentrated in the tonsils. Monkeypox symptoms were managed with different antiretroviral and antimicrobial medications to reduce pain and fever.
Although each patient may experience unique initial symptoms, looking for an ulcer located at the corner of the mouth may be an early indicator of monkeypox infection. Early detection is helpful when seeking treatment and can decrease the severity of the viral infection when treated.
Sources:
Aerzteblatt, Eureka News Alert, Journal of Oral Pathology and Medicine
