New Microbes and New Infections (Mar 2023)
Characteristics of confirmed mpox cases among clinical suspects: A prospective single-centre study in Belgium during the 2022 outbreak
- Matilde Hens,
- Isabel Brosius,
- Nicole Berens-Riha,
- Jasmine Coppens,
- Liesbeth Van Gestel,
- Jojanneke Rutgers,
- Chris Kenyon,
- Patrick Soentjens,
- Saskia van Henten,
- Stefanie Bracke,
- Thibaut Vanbaelen,
- Leen Vandenhoven,
- Emmanuel Bottieau,
- Koen Vercauteren,
- Marjan Van Esbroeck,
- Laurens Liesenborghs,
- Christophe Van Dijck,
- Christophe Van Dijck,
- Matilde Hens,
- Marjan Van Esbroeck,
- Isabel Brosius,
- Laurens Liesenborghs,
- Liesbeth Van Gestel,
- Jojanneke Rutgers,
- Chris Kenyon,
- Irith De Baetselier,
- Jasmine Coppens,
- Dorien Van den Bossche,
- Eric Florence,
- Koen Vercauteren,
- Johan van Griensven,
- Emmanuel Bottieau,
- Patrick Soentjens,
- Nicole Berens-Riha,
- Saskia van Henten,
- Stefanie Bracke,
- Thibaut Vanbaelen,
- Leen Vandenhoven,
- Maartje Van Frankenhuijsen,
- Marc Vandenbruaene,
- Veerle Huyst,
- Kristien Wouters,
- Ludwig Apers,
- Ilse Kint,
- Séverine Caluwaerts,
- Fien Vanroye,
- Jacob Verschueren,
- Kevin Ariën
Affiliations
- Matilde Hens
- Department of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium; Corresponding author. Institute of Tropical Medicine, Kronenburgstraat 43, 2000, Antwerpen, Belgium.
- Isabel Brosius
- Department of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium
- Nicole Berens-Riha
- Department of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium
- Jasmine Coppens
- Department of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium
- Liesbeth Van Gestel
- Department of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium
- Jojanneke Rutgers
- Department of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium
- Chris Kenyon
- Department of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium
- Patrick Soentjens
- Department of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium
- Saskia van Henten
- Department of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium
- Stefanie Bracke
- Department of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium
- Thibaut Vanbaelen
- Department of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium
- Leen Vandenhoven
- Department of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium
- Emmanuel Bottieau
- Department of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium
- Koen Vercauteren
- Department of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium
- Marjan Van Esbroeck
- Department of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium
- Laurens Liesenborghs
- Department of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium
- Christophe Van Dijck
- Department of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium; Laboratory of Medical Microbiology, University of Antwerp, Belgium
- Christophe Van Dijck
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium; Laboratory of Medical Microbiology, University of Antwerp, Belgium
- Matilde Hens
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
- Marjan Van Esbroeck
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
- Isabel Brosius
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
- Laurens Liesenborghs
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
- Liesbeth Van Gestel
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
- Jojanneke Rutgers
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
- Chris Kenyon
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium; Division of Infectious Diseases and HIV Medicine, University of Cape Town, Cape Town, South Africa
- Irith De Baetselier
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
- Jasmine Coppens
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
- Dorien Van den Bossche
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
- Eric Florence
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium; University Hospital Antwerp, Belgium
- Koen Vercauteren
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
- Johan van Griensven
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
- Emmanuel Bottieau
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
- Patrick Soentjens
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
- Nicole Berens-Riha
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
- Saskia van Henten
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
- Stefanie Bracke
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
- Thibaut Vanbaelen
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
- Leen Vandenhoven
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
- Maartje Van Frankenhuijsen
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
- Marc Vandenbruaene
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
- Veerle Huyst
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
- Kristien Wouters
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
- Ludwig Apers
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
- Ilse Kint
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
- Séverine Caluwaerts
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
- Fien Vanroye
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
- Jacob Verschueren
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
- Kevin Ariën
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
- Journal volume & issue
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Vol. 52
p. 101093
Abstract
Background: The presentation of mpox clade IIb during the 2022 outbreak overlaps with a range of other diseases. Understanding the factors associated with mpox is important for clinical decision making. Methods: We described the characteristics of mpox patients who sought care at Belgian sexual health clinic. Furthermore we compared their characteristics to those of patients with a clinical suspicion of mpox but who tested negative on polymerase chain reaction. Results: Between May 23 and September 20, 2022, 155 patients were diagnosed with mpox, and 51 patients with suspected symptoms tested negative. All mpox patients self-identified as men and 148/155 (95.5%) as gay or bisexual MSM. Systemic symptoms were present in 116/155 (74.8%) patients. All but 10 patients (145/155, 93.5%) presented with skin lesions. Other manifestations were lymphadenopathy (72/155, 46.5%), proctitis (50/155, 32.3%), urethritis (12/155, 7.7%), tonsillitis (2/155, 1.3%). Complications involved bacterial skin infection (13/155, 8.4%) and penile oedema with or without paraphimosis (4/155, 2.6%). In multivariable logistic regression models, the presence of lymphadenopathy (OR 3.79 95% CI 1.44–11.49), skin lesions (OR 4.35 95% CI 1.15–17.57) and proctitis (OR 9.41 95% CI 2.72–47.07) were associated with the diagnosis of mpox. There were no associations with age, HIV status, childhood smallpox vaccination, number of sexual partners and international travel. Conclusions: The presence of proctitis, lymphadenopathies and skin lesions should increase clinical suspicion of mpox in patients with compatible symptoms.