Skin lesion specimens have been identified as the primary choice to detect the monkeypox virus. Monkeypox is a rare but potentially severe viral disease that is endemic in Central and West Africa. It is caused by the Monkeypox virus, a member of the Orthopoxvirus family, which includes the variola (smallpox) virus. Skin lesions, ranging from papules to pustules, are the primary clinical manifestation of monkeypox infection. Thus, the collection and analysis of skin lesion specimens is crucial in the diagnosis of this viral disease. In this article, we will explore why skin lesion specimens are considered the best choice for detecting monkeypox virus and its implications in public health.
The article discusses concerns about the accuracy of the diagnosis of monkeypox virus in a patient presented in the Clinical Picture. The authors appreciate the electron microscopy images of monkeypox virus infection presented by Markus Müller and colleagues but raise several issues regarding the diagnostic approach utilized in the patient presented in the Clinical Picture.
The authors highlight that previous studies have revealed that skin lesion specimens are the best choice to detect monkeypox virus. However, the PCR tests for monkeypox virus in this patient were conducted in anorectal and oropharyngeal swabs instead of skin swabs, which raises concerns about the accuracy of the diagnosis.
Additionally, the authors mention that localized lymphadenopathy is usually present in patients with mpox and is the most important sign differentiating it from smallpox and chickenpox. However, lymphadenopathy was not mentioned in this patient, further questioning the accuracy of the diagnosis.
The article also highlights that concurrent sexually transmitted infections are common among patients with mpox, but the tissue samples for this patient were only tested for herpes simplex virus, Chlamydia trachomatis, and Neisseria gonorrhoea. The authors suggest that at least serological tests for syphilis and HIV should be conducted given the patient’s sexual history.
The authors acknowledge that positive PCR results for monkeypox virus in anorectal and oropharyngeal swabs were sufficient to make a diagnosis of mpox in this case. However, they suggest that histopathological examination is unnecessary as it is traumatic and time-consuming.
In conclusion, this article raises concerns about the diagnostic approach utilized in a patient presented in the Clinical Picture with monkeypox virus. The authors emphasize the importance of utilizing accurate diagnostic methods, such as skin lesion specimens, and conducting appropriate tests, including for concurrent sexually transmitted infections, in patients with mpox.
In conclusion, skin lesion specimens have proven to be the most effective and reliable method for detecting monkeypox virus. With the increasing global spread of this disease and the potential for outbreaks, accurate and efficient diagnostic methods are critical for effective control and management. By prioritizing skin lesion specimens in the diagnostic process, we can improve our ability to identify and contain monkeypox virus, ultimately preventing its spread and protecting public health. As research and technology continue to advance, we can remain hopeful that even more innovative and efficient diagnostic methods will be developed to further enhance our ability to combat this deadly virus.
