Otolaryngologic manifestations of Mpox: the Atlanta outbreak

Abstract

Background

In 2022, Mpox (MPX) has become clinically relevant as otolaryngologists are evaluating this exotic disease process due to its many otolaryngologic manifestations.

Aims/Objective

To characterize our cohort of otolaryngology-relevant MPX confirmed cases.

Materials and methods

A descriptive case series was performed via retrospective review. Adult patients who underwent inpatient or emergency department otolaryngology consultation at an Emory University-affiliated tertiary care level hospital for MPX were included.

Results

Seven patients (age 18–58 years; median 32 years) were identified. All patients were male. Six patients (86%) were black and six patients (86%) were HIV positive with varied immunocompetence. Otolaryngology was consulted for lymphadenopathy (n = 2), pharyngeal involvement (n = 1), and airway evaluation (n = 4). All 6 patients with active MPX developed the classic rash, which developed after oropharyngeal symptoms in 3 patients. Three patients had laryngeal involvement.

Conclusion

MPX manifests with symptoms requiring otolaryngology expertise, especially when the airway is involved. Infectious disease consultation is key. Mpox can be identified with a specific constellation of demographic identifiers and physical exam findings, which is key to determining appropriate treatment and protection for the consulting otolaryngologist.

Significance

This is the first otolaryngologic study of Mpox and first description of Mpox laryngeal involvement.

Chinese Abstract

背景：2022 年, 当耳鼻喉科医生在评估 Mpox (MPX) 这一奇异疾病的发展过程时, 它变得具有临床相关性, 因其有许多耳鼻喉科的表征。

目的：确定我们的耳鼻喉科相关 MPX 确诊病例群的特征。

材料和方法：通过回顾性审查进行描述性病例系列。 纳入因MPX在埃默里大学附属三级医院接受住院或急诊耳鼻喉科咨询的成人患者。

结果：确定了 7 名患者（年龄 18-58 岁；中位年龄 32 岁）。 所有患者均为男性。 6名

患者 (86%) 为黑人, 6 名患者 (86%) 为 HIV 阳性且免疫能力各不相同。就淋巴结肿大 (n = 2)、咽部受累 (n = 1) 和气道评估 (n = 4) 咨询耳鼻喉科。 所有 6 名患有活动性 MPX 的患者都出现了典型的皮疹, 3例的皮疹发展为后口咽症状。 三名患者有咽部受累。

结论：MPX 表现出的症状需要耳鼻喉科专业知识, 尤其是当涉及气道时。 传染病会诊是关键。 Mpox 可以通过一组特定的人口统计标识符和体格检查结果来识别, 这是为咨询的耳鼻喉科医生确定适当治疗方法和保护措施的关键。

意义：这是第一次对 Mpox 的耳鼻喉科研究, 也是第一次描述 Mpox 咽部受累。

Keywords:

• Mpox
• monkeypox
• 2022 mpox outbreak
• otolaryngology consultation
• maculopustular rash
• lymphadenopathy
• orthopoxvirus
• laryngeal lesions

Disclosure statement

No potential conflict of interest was reported by the author(s).