1
|
Álvarez-Moreno CA, Reveiz L, Aristizabal C, Quevedo J, Rubio MLM, Arévalo-Mora L, Villamil JFP, Padilla M, Alzate-Angel JC, Rylance J, Firdavs K, de la Hoz I, Valderrama-Beltran SL, Arboleda S, Sussmann O, Andrade J, Velásquez CM, García E, Galindo X, Martínez D, Arango L, Martínez E, Reyes-Caicedo K, Suarez MM, Ríos JG, Garay A, Pinzón W, Crispin AM, Chaillon A. Mpox: Characterization and clinical outcomes of patients in Colombian healthcare institutions. GLOBAL EPIDEMIOLOGY 2025; 9:100197. [PMID: 40242136 PMCID: PMC12002742 DOI: 10.1016/j.gloepi.2025.100197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2024] [Revised: 03/09/2025] [Accepted: 03/09/2025] [Indexed: 04/18/2025] Open
Abstract
Introduction In 2022, the world experienced a monkeypox outbreak caused by the Clade IIb strain of the virus. While this outbreak had widespread effects, more information is needed on mpox's specific impact in Colombia, particularly regarding how it is managed, its burden, and its epidemiology. This research seeks to examine the medical context, clinical presentation, and health outcomes of individuals diagnosed with mpox infection, with a particular focus on those with HIV in Colombia. Methods This retrospective study was conducted in fourteen Health institutions in Colombia based on computerized clinical records from Jan 2022 to Dec 2023. Clinical and epidemiological characteristics were collected from diagnosis until discharge (or death). Participants in the study were diagnosed through molecular methods (PCR) and their clinical evolution was tracked through hospital and/or outpatient medical records. Registered variables were based on the mpox 2023 Case Report Form (2023 - CRF) proposed by the World Health Organization. Results One thousand four hundred thirteen (1413, 97.2 % male) individuals, including 2.6 % identified as healthcare workers, were included in this study. The majority (54 %, 764/1413 individuals) were persons living with HIV (PWH) and almost one-third of them (30.1 %, n = 284) of participants had concomitant sexually transmitted diseases and HIV, with syphilis being the most prevalent (20.4 %), followed by Neisseria gonorrhoeae (16.4 %). Complications were infrequent, with cellulitis being the most common, and no individuals received mpox-specific treatment or vaccination. Although all individuals had skin lesions distributed across various body regions, differences were noted in lesion distribution among women. Those living with HIV showed higher emergency department attendance and reported having known mpox contacts. While complications were rare, with cellulitis being the most common, women living with HIV showed a higher rate of emergency room visits and known mpox contacts. Although not statistically significant, gastrointestinal, musculoskeletal, psychological, respiratory, and STI symptoms, including syphilis and urethritis, were more common in the virologically non-suppressed HIV group. At the same time, proctitis was more prevalent in the suppressed group. No significant differences were found based on CD4 count, using 200 cells/mm3 in PWH. Conclusion Over half of the participants were people living with HIV (PWH), with a significant presence of STIs like syphilis. While skin lesions and complications varied, no significant differences were linked to CD4 count or viral load suppression. Mpox symptomatology was not significantly associated with unsuppressed viral loads or low CD4 levels, highlighting the need for further research.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | - Santiago Arboleda
- Hospital Universitario San Ignacio, Pontificia Universidad Javeriana, Bogota, Colombia
| | | | | | | | | | | | | | | | - Ernesto Martínez
- Hospital Universitario del Valle, Universidad del Valle, Cali, Colombia
| | | | | | | | | | | | | | | |
Collapse
|
2
|
Morales-Múnera CE, Montoya F, de Loredo N, Sendagorta E. AEDV Expert Document on the Management of Ulcerative Venereal Infections. ACTAS DERMO-SIFILIOGRAFICAS 2025; 116:159-168. [PMID: 38556200 DOI: 10.1016/j.ad.2024.03.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Revised: 02/20/2024] [Accepted: 03/13/2024] [Indexed: 04/02/2024] Open
Abstract
Currently, ulcerative sexually transmitted infections, including syphilis, herpes simplex virus (HSV), lymphogranuloma venereum (LGV), chancroid, donovanosis and, more recently, monkeypox (MPOX), represent a growing challenge for health care professionals. The incidence of syphilis and LGV has increased in recent years in Spain. Additionally, HSV, syphilis and chancroid can also increase the risk of HIV acquisition and transmission. The population groups most vulnerable to these infections are young people, men who have sex with men (MSM) and commercial sex workers. It is important to make a timely differential diagnosis since genital, anal, perianal, and oral ulcerative lesions may pose differential diagnosis with other infectious and non-infectious conditions such as candidiasis vulvovaginitis, traumatic lesions, carcinoma, aphthous ulcers, Behçet's disease, fixed drug eruption, or psoriasis. For this reason, the dermatologist plays a crucial role in the diagnosis and management of sexually transmitted infections. This chapter presents the main epidemiological, clinical and therapeutic features associated with these infections.
Collapse
Affiliation(s)
- C E Morales-Múnera
- Servicio de Dermatología, Hospital de la Santa Creu i Sant Pau, Barcelona, España
| | - F Montoya
- Unidad de VIH, Servicio de Enfermedades Infecciosas, Hospital Clínic, Barcelona, España
| | - N de Loredo
- Unidad de VIH, Servicio de Enfermedades Infecciosas, Hospital Clínic, Barcelona, España
| | - E Sendagorta
- Servicio de Dermatología, CIBERINFEC, Hospital La Paz, Madrid, España.
| |
Collapse
|
3
|
Pathania YS. Comment on "MPOX (Formerly Monkeypox): Review on the Most Relevant Clinical, Epidemiological, Diagnostic and Therapeutic Aspects for the Dermatologist". ACTAS DERMO-SIFILIOGRAFICAS 2025; 116:T204-T206. [PMID: 39566734 DOI: 10.1016/j.ad.2024.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2024] [Accepted: 07/21/2024] [Indexed: 11/22/2024] Open
Affiliation(s)
- Y S Pathania
- Department of Dermatology, Venereology and Leprology, All India Institute of Medical Sciences, Rajkot, Gujarat, India.
| |
Collapse
|
4
|
Morales-Múnera CE, Montoya F, de Loredo N, Sendagorta E. [Translated article] AEDV Expert Document on the Management of Ulcerative Venereal Infections. ACTAS DERMO-SIFILIOGRAFICAS 2025; 116:T159-T168. [PMID: 39566736 DOI: 10.1016/j.ad.2024.11.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Revised: 02/20/2024] [Accepted: 03/13/2024] [Indexed: 11/22/2024] Open
Abstract
Currently, ulcerative sexually transmitted infections, including syphilis, herpes simplex virus (HSV), lymphogranuloma venereum (LGV), chancroid, donovanosis and, more recently, monkeypox (MPOX), represent a growing challenge for health care professionals. The incidence of syphilis and LGV has increased in recent years in Spain. Additionally, HSV, syphilis and chancroid can also increase the risk of HIV acquisition and transmission. The population groups most vulnerable to these infections are young people, men who have sex with men (MSM) and commercial sex workers. It is important to make a timely differential diagnosis since genital, anal, perianal, and oral ulcerative lesions may pose differential diagnosis with other infectious and non-infectious conditions such as candidiasis vulvovaginitis, traumatic lesions, carcinoma, aphthous ulcers, Behçet's disease, fixed drug eruption, or psoriasis. For this reason, the dermatologist plays a crucial role in the diagnosis and management of sexually transmitted infections. This chapter presents the main epidemiological, clinical and therapeutic features associated with these infections.
Collapse
Affiliation(s)
- C E Morales-Múnera
- Servicio de Dermatología, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - F Montoya
- Unidad de VIH, Servicio de Enfermedades Infecciosas, Hospital Clínic, Barcelona, Spain
| | - N de Loredo
- Unidad de VIH, Servicio de Enfermedades Infecciosas, Hospital Clínic, Barcelona, Spain
| | - E Sendagorta
- Servicio de Dermatología, CIBERINFEC, Hospital La Paz, Madrid, Spain.
| |
Collapse
|
5
|
Pathania YS. Comment on "MPOX (Formerly Monkeypox): Review on the Most Relevant Clinical, Epidemiological, Diagnostic and Therapeutic Aspects for the Dermatologist". ACTAS DERMO-SIFILIOGRAFICAS 2025; 116:204-205. [PMID: 39271007 DOI: 10.1016/j.ad.2024.07.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2024] [Accepted: 07/21/2024] [Indexed: 09/15/2024] Open
Affiliation(s)
- Y S Pathania
- Department of Dermatology, Venereology and Leprology, All India Institute of Medical Sciences, Rajkot, Gujarat, India.
| |
Collapse
|
6
|
Velásquez JS, Herrera-Echeverría FB, Porres-Paredes HS, Rodríguez-Cerdeira C. Understanding the Epidemiology of Monkeypox Virus to Prevent Future Outbreaks. Microorganisms 2024; 12:2576. [PMID: 39770778 PMCID: PMC11678333 DOI: 10.3390/microorganisms12122576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2024] [Revised: 11/16/2024] [Accepted: 12/08/2024] [Indexed: 01/11/2025] Open
Abstract
Monkeypox (Mpox) is an infectious disease caused by the Mpox virus belonging to the Orthopoxvirus genus in the Poxviridae family and has been declared by the WHO as a global health emergency owing to its rapid spread during 2022 and 2023. All patients diagnosed with Mpox who were confirmed by PCR between July 2022 and April 2023 were included in this study. In total, 405 patients in whom clade 2 was identified were included. Notably, 99% of included patients were men, with 82% of them aged 20-39 years. Furthermore, 71% were men who had sex with men, and 34% were HIV carriers. Regarding the morphology of the lesions, approximately 63% presented with papulonecrotic rash, which sometimes alternated with pustules depending on the stage they were in. All patients presented with systemic symptoms. Five patients required hospital admission, one of whom died, and presented with HIV and severe immunosuppression. Clinical findings suggest that contact during sexual intercourse is the most likely transmission mechanism and genital involvement is the most frequent clinical form. HIV was the primary comorbidity. Genital lesions were common, especially in vulnerable populations such as those who engage in high-risk sexual behaviors.
Collapse
Affiliation(s)
- Jimmy Steven Velásquez
- Dermatology Department, Hospital Regional de Occidente San Juan de Dios, Quetzaltenango 09001, Guatemala; (J.S.V.); (H.S.P.-P.)
- Fundación Vithas, Grupo Hospitalario Vithas, 28043 Madrid, Spain
- Ibero-Latin American College of Dermatology (CILAD), Buenos Aires C1091, Argentina
| | | | - Héctor Salvador Porres-Paredes
- Dermatology Department, Hospital Regional de Occidente San Juan de Dios, Quetzaltenango 09001, Guatemala; (J.S.V.); (H.S.P.-P.)
| | - Carmen Rodríguez-Cerdeira
- Fundación Vithas, Grupo Hospitalario Vithas, 28043 Madrid, Spain
- Ibero-Latin American College of Dermatology (CILAD), Buenos Aires C1091, Argentina
- Dermatology Department, Grupo Hospitalario (CMQ Concheiro), Manuel Olivié 11, 36203 Vigo, Spain
- Department of Health Sciences, University of Vigo, Campus of Vigo, As Lagoas, 36310 Vigo, Spain
| |
Collapse
|
7
|
Rodríguez Parejo G, Montero Peña C, Lacambra Blasco RD. [Monkeypox infection]. Semergen 2024; 50:102126. [PMID: 38159343 DOI: 10.1016/j.semerg.2023.102126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 09/18/2023] [Indexed: 01/03/2024]
Affiliation(s)
| | - C Montero Peña
- Centro de Salud, Don Benito-Villanueva de la Serena, Badajoz, España
| | | |
Collapse
|