Schoenwald - Monkeypox Flashcards
what type of virus is monkeypox
orthopoxvirus
how is monkeypox spread
close/direct contact w.:
lesions
bodily fluids
respiratory secretions
objects w. spores
animal/animal products
vertical → mother to fetus
early sx of monkeypox are similar to __, but milder
and include (7)
small pox
fever, HA, muscle aches, backache, LAD, chills, exhaustion
1-3 days after the appearance of __,
__ sx occur (2)
fever
rash, lesions
what stages do monkeypox lesions progress thru over 2-3 weeks
macules
papules
vesicles/pustules
scabs
can also be umbilicated
what distinguishes monkeypox prodrome from smallpox
LAD
ddx for monkeypox rash
syphilis
herpes
varicella
molluscum contagiosum
smallpox
chicken pox starts __
and spreads __
centrally
outwards
what is this
molluscum contagiousum
what is this
HSV
what is this
syphilis
key characteristics for identifying monkeypox lesions
well circumscribed
deep seeded
often umbilicated
same size and stage on single body site
lesions on palms/toes
painful → crust → itchy
2 key characteristics of monkeypox prodrome
fever prior to rash
LAD
describe disseminated rash in monkeypox
centrifulgal → more on face/extremities than central
3 stages of monkeypox illness
incubation → 5-21 days
prodrome → 1-3 days
rash → 2-3 weeks
which stages of monkeypox is pt contagious
prodrome
rash
pt w. monkeypox is contagious until
all scabs have fallen off
AND
fresh layer of intact skin has formed underneat
enathem thru scab stage
enathem
macules
papules
vesicles
pustules
scabs
CDC definition of monkeypox
new characteristic rash
PLUS:
contact w. person w. similar rash and confirmed/probably monkeypox
close or intimate contact w. monkeypox
traveled outside US w. confirmed cases
contact w. dead or live wild animal or exotic African species or used a product from such animal
CDC definition includes MSM who
meet partners thru online website, app, or social event
dx test for monkeypox
PCR of lesion material
should use mask and shield
t/f: pt must isolate at home until monkeypox case is confirmed/ruled out
T!
how long must pt w. confirmed monkeypox isolate
until all scabs fall off
t/f: most cases of monkeypox are mild/self limiting
T!
complications of severe monkeypox
hemorrhagic dz
confluent lesions
sepsis
encephalitis
PNA
pops at high risk of severe dz
immunocompromised (including solid organ transplant)
peds < 8 yo
pregnant/breastfeeding
hx atopic dermatitis, eczema, burns etc (derm conditions)
one or more complications from lesions: gastroenteritis, dehydration, bronchopna, concurrent infxn
comorbidities
t/f: there is no specific tx for monkeypox
T!
antivirals to try for monkeypox
tecovirimat
cidofivir
vaccinia immune globulin
what virus is cidofivir approved for
CMV
post exposure prophylaxis for monkeypox in CO
jynneos vaccine
is jynneos used for tx of monkeypox
nope - just PEP
who gets PEP
close contacts after consult w. health dept
