Absence of association between persistent skin lesion and virological replication in severe disseminated monkeypox infection in solid organ transplant recipient - 01/09/23
Highlights |
• | A clinical report on a severe Monkeypox infection in a solid organ transplant recipient requiring tecovirimat therapy with 3 consecutive rashes. |
• | The most important finding is a significant association between positive viral cultures - only in skin lesions in of each successive rash - and low Monkeypox RT-PCR Ct-values (under a threshold of 19.45). |
• | No positive viral cultures were obtained from long-term persistent skin lesions after 23 days of evolution, despite Ct-values lower than previously reported to be associated with non-infectivity (Ct-value under 35). |
• | No positive viral culture was observed from oro-pharyngeal samples after 12 days of disease evolution. |
Abstract |
The Monkeypox (mpox) virus outbreak has been controlled worldwide. We report the case of a combined pancreas-kidney transplant recipient who presented a severe and prolonged cutaneous infection with onset of 3 successive rashes while receiving tecovirimat therapy. During follow-up, skin lesions, blood and throat samples were collected. Viral culture and mpox PCR were performed. No positive viral culture was obtained from blood and throat. The lowest mpox CT-values were obtained early after onset of skin lesions and were more likely to be associated with positive viral cultures. Furthermore, we observed persistent skin lesions up to 3 months. On these persistent lesions, mpox PCR positives were obtained but were not associated with positive viral culture after 23 days. In this immunocompromised host, who was receiving tecovirimat, in accordance with existing recommendations a 21-day isolation period appeared to be adapted. That said, isolation should not be systematically extended if complete healing of skin lesions has not been achieved.
Le texte complet de cet article est disponible en PDF.Keywords : Immunocompromised patient, Monkeypox, Tecovirimat, Viral load
Abbreviations : CDC, CPE, Ct, mpox, PCR, TAU, WHO
Plan
Vol 53 - N° 6
Article 104749- septembre 2023 Retour au numéro
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