Document Detail


Human monkeypox: confusion with chickenpox.
MedLine Citation:
PMID:  2907258     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Human monkeypox is a zoonosis occurring sporadically in the tropical rain forest of western and central Africa. The exact incidence and geographical distribution are unknown, since many cases are not recognized. Special surveillance was established in three regions in Zaire in 1981 that led to a substantial increase in reported cases. The question arose as to the possibility that clinical diagnostic errors cause some cases of monkeypox to be misdiagnosed as other eruptive diseases. This paper presents the results of a study assessing the extent of and reasons for these clinical diagnostic errors in areas where health staff as well as the general public are aware of human monkeypox. In Zaire in the period 1981-1986, 977 persons with skin eruption not clinically diagnosed as human monkeypox were laboratory tested. 3.3% of human monkeypox cases were found among 730 patients diagnosed as cases of chickenpox, 7.3% among cases diagnosed as "atypical chickenpox" and 6.1% among cases with skin rash for which clinical diagnosis could not be established. The diagnostic difficulties were mainly based on clinical features characteristic of chickenpox: regional pleomorphism (in 46% of misdiagnosed cases), indefinite body-distribution of skin eruptions (49%), and centripetal distribution of skin lesions (17%). Lymph-node enlargement was observed in 76% of misdiagnosed patients. In the absence of smallpox, the main clinical diagnostic problem is the differentiation of human monkeypox from chickenpox. The presence of lymphadenopathy, pre-eruptive fever and slower maturation of skin lesions are the most important clinical signs supporting correct diagnosis of monkeypox.
Authors:
Z Jezek; M Szczeniowski; K M Paluku; M Mutombo; B Grab
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Acta tropica     Volume:  45     ISSN:  0001-706X     ISO Abbreviation:  Acta Trop.     Publication Date:  1988 Dec 
Date Detail:
Created Date:  1989-05-02     Completed Date:  1989-05-02     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0370374     Medline TA:  Acta Trop     Country:  NETHERLANDS    
Other Details:
Languages:  eng     Pagination:  297-307     Citation Subset:  IM    
Affiliation:
Communicable Diseases Division, World Health Organization, Geneva, Switzerland.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Age Factors
Antibodies, Viral / analysis
Chickenpox / diagnosis*,  epidemiology
Child
Child, Preschool
Communicable Disease Control
Democratic Republic of the Congo
Diagnosis, Differential
Exanthema / diagnosis
Female
Humans
Infant
Lymph Nodes / analysis
Male
Monkeypox virus
Population Surveillance
Poxviridae Infections / diagnosis*,  epidemiology
Serologic Tests
Sex Factors
Chemical
Reg. No./Substance:
0/Antibodies, Viral

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