Encephalomyelitis in a patient with monkeypox: an unusual complication

A new outbreak of monkeypox has been reported worldwide with CNS complications like encephalitis or myelitis being extremely rare. We present a case of a 30-year-old man with PCR-confirmed diagnosis of monkeypox who developed rapid neurological deterioration with extensive inflammatory involvement o...

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Bibliographic Details
Published in:	Journal of neurovirology Vol. 29; no. 2; pp. 237 - 240
Main Authors:	Marín-Medina, Daniel S., Castilla-Gómez, Laura, Poveda, Marcela, Ortiz, Leonora, Ariza-Serrano, Lina M., Schlesinger-Piedrahita, Antonio, Torres-Zafra, Javier, Tapias-Agamez, Manuel, Osorio-Lombana, Juan Pablo, Arias-León, Gerson, Silva, Edwin
Format:	Journal Article
Language:	English
Published:	Cham Springer International Publishing 01-04-2023
Subjects:	Adult Antiviral Agents - therapeutic use Biomedical and Life Sciences Biomedicine Brain - diagnostic imaging Case Report Encephalomyelitis - complications Encephalomyelitis - diagnostic imaging Encephalomyelitis - drug therapy Encephalomyelitis, Acute Disseminated - complications Encephalomyelitis, Acute Disseminated - diagnostic imaging Encephalomyelitis, Acute Disseminated - drug therapy Humans Immunology Infectious Diseases Magnetic Resonance Imaging Male Mpox (monkeypox) - complications Mpox (monkeypox) - drug therapy Neurology Neurosciences Virology Myelitis Encephalitis Acute disseminated encephalomyelitis Encephalomyelitis Monkeypox
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Summary:	A new outbreak of monkeypox has been reported worldwide with CNS complications like encephalitis or myelitis being extremely rare. We present a case of a 30-year-old man with PCR-confirmed diagnosis of monkeypox who developed rapid neurological deterioration with extensive inflammatory involvement of the brain and spinal cord on MRI. Because of the clinical and radiological resemblance to acute disseminated encephalomyelitis (ADEM), it was decided to indicate treatment with high-dose corticosteroids for 5 days (without concomitant antiviral management due to lack of availability in our country). Given the poor clinical and radiological response, 5 days of immunoglobulin G were administered. During follow-up the patient’s clinical condition improved, physiotherapy was started and all associated medical complications were controlled. To our knowledge, this is the first reported monkeypox case with severe CNS complications treated with steroids and immunoglobulin in the absence of specific antiviral treatment.
Bibliography:	ObjectType-Case Study-2 SourceType-Scholarly Journals-1 ObjectType-Feature-4 content type line 23 ObjectType-Report-1 ObjectType-Article-3
ISSN:	1355-0284 1538-2443
DOI:	10.1007/s13365-023-01121-7