MonkeyPox might be initially easily overlooked and mistaken for other diseases, 

Last Updated on January 11, 2023 by Dr Bucho


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Researchers described the characteristics of MPX cases among MSM initially misdiagnosed with some other disease

MonkeyPox: Outside of Africa, monkeypox (MPX) is a disease that is starting to spread, particularly among men who have sex with men (MSM) who engage in unprotected intercourse [1]. More than 60,000 cases have been confirmed outside of endemic areas since its first appearance in the current outbreak on early May 2022. CDC

Queer men appear to have learned more from AIDS and Covid-19 than the authorities did, which is one of the main reasons why the epidemic has largely stopped.

This summer, there were a few weeks when the monkeypox outbreak caused concern around the world. The US was recording 600 instances per day at its peak in early August, and the health officials’ bungled response was reminiscent of Covid-19’s early stages. For the majority of the fall, vaccinations were hard to come by and in short supply. There was a testing backlog.

Although antiviral medications were available, they were almost impossible to obtain because the federal government had not approved them for the illness. Although the majority of cases were in homosexual and bisexual males, there were concerns that the infection, which is seldom fatal but frequently highly painful and can take weeks to decrease, would spread to a larger community.


According to recent Studies published in the International Journal of Infectious Diseases (IJID), During the 2022 outbreak, cases of monkeypox among males who had sex with men were overlooked. Here are the Highlights of The study:

  • Monkey Pox in the present outbreak out of endemic areas may be easily overlooked.
  • Monkey Pox may be present as another sexually transmitted diseases.
  • Misdiagnosis led to delayed isolation and administration of inappropriate treatment.

Monkeypox is seen as a sexually transmitted infection

The idea that testing, immunization, and case tracking may now be considered standard aspects of medical care appears to be the foundation of the notion that monkeypox no longer warrants emergency classification. The issue with that notion is that monkeypox is seen as a sexually transmitted infection (albeit it is still unclear if it is transmitted through sex as opposed to casual skin contact).

This places it under the jurisdiction of sexual health clinics, which are often run by local and state health departments. Before the monkeypox outbreak, those clinics were already overburdened because STIs reached an all-time high in the US last spring. Federal clinic funding, meanwhile, has decreased by 40% since 2003, according to a 2021 study by the National Academies of Sciences, Engineering, and Medicine.

The Study And Its Findings

Researchers in the current study examined the traits of MPX instances among MSM who were initially given the wrong diagnosis for another illness. Between May 16 and October 6, 2022, patients who received a diagnosis of MPX were included. Misdiagnosis was described as failing to recognize Monkeypox during the initial examination but later confirming it as a result of a lab test.

Just Patients with a polymerase chain reaction (PCR) test-based diagnosis were included. The total number of patients who self-identified as MSM and had a history of sex contact was 26. During their initial evaluation, the doctor did not ask these subjects if they had ever interacted with an MPX patient. HIV pre-exposure prophylaxis was being taken by 17 individuals, five of whom were positive for the infection (PrEP). Newsmedical

Initial misdiagnoses for six MPX cases included bacterial tonsillitis, six for syphilis, five for herpes, and four for proctitis. Doctors who made incorrect diagnoses included proctologists, dermatologists, and primary/emergency care physicians. Twenty-one doctors, either specialists in infectious diseases or emergency/primary care physicians, correctly identified MPX. The average number of days between a missed diagnosis and a right one was 4.4 days


The study’s findings showed that MPX could be first ignored or confused with other illnesses, including STIs. Due to its non-classical anogenital lesion presentation and method of transmission, MPX is often mistaken for other STIs including syphilis and herpes. Pharyngitis/tonsillitis was identified in about 23% of individuals as a result of oropharyngeal lesions.

Nine people in all had co-infections (five had HIV, and four had bacterial STIs). The current MPX outbreak has disproportionately affected people who have STIs or HIV. Testing for STI co-infections is crucial because many patients are on PrEP and almost certainly engaged in unprotected sexual activity. For fast and accurate diagnosis of MPX and to stop its spread, continued awareness of the disease’s clinical symptoms and indicators is required.

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