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Open Access 16-01-2024 | Mpox | Case Report

Monkeypox virus-associated meningoencephalitis diagnosed by detection of intrathecal antibody production

Authors: Hansen Karin, Båtshake Ylva, Söderholm Sandra, Pettke Aleksandra, Björkman Per, Sondén Klara

Published in: BMC Infectious Diseases | Issue 1/2024

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Abstract

Background

In the 2022 mpox-outbreak most patients presented with mild symptoms. Central nervous system (CNS) involvement has previously been described as a rare and severe complication of mpox; however, diagnostic findings in cerebrospinal fluid (CSF) analysis and neuroimaging studies have only been reported in one case previously.

Case presentation

We report a previously healthy 37-year-old man with mpox complicated by encephalitis. He first presented with painful skin lesions and genital ulcers; polymerase chain reaction (PCR) from the lesions was positive for mpox. Twelve days later he was admitted with fever and confusion. Neuroimaging and CSF analysis indicated encephalitis. The CSF was PCR-negative for monkeypox virus but intrathecal antibody production was detected. He spontaneously improved over a few days course and recovered fully.

Conclusions

This case of mpox-associated encephalitis shows that CNS involvement in mpox infection may have a relatively mild clinical course, and that detection of intrathecal antibody production can be used to establish the diagnosis if CSF monkeypox virus-PCR is negative.
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Metadata
Title
Monkeypox virus-associated meningoencephalitis diagnosed by detection of intrathecal antibody production
Authors
Hansen Karin
Båtshake Ylva
Söderholm Sandra
Pettke Aleksandra
Björkman Per
Sondén Klara
Publication date
16-01-2024
Publisher
BioMed Central
Published in
BMC Infectious Diseases / Issue 1/2024
Electronic ISSN: 1471-2334
DOI
https://doi.org/10.1186/s12879-024-09000-0

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