Miami study sounds alarm that Mpox can also cause gastrointestinal complications and inflammation of the rectum!

Mpox News: Mpox, previously known as monkeypox, has long been recognized for its dermatological symptoms, but recent findings reveal a more troubling aspect: gastrointestinal (GI) complications. A study conducted by researchers from the University of Miami Leonard Miller School of Medicine-USA has shed light on this emerging concern. This Mpox News article will explore the study's key findings, which highlight the GI manifestations of Mpox, an area that has received little attention until now.


Miami study sounds alarm that Mpox can also cause gastrointestinal
complications and inflammation of the rectum

A Brief Overview of Mpox
The Mpox virus, a member of the Orthopoxvirus family, was first identified in humans in 1970 in the Democratic Republic of Congo. While the virus remained largely confined to Central Africa for decades, the 2022 outbreak marked a significant shift in its epidemiology. The World Health Organization (WHO) declared Mpox a Public Health Emergency of International Concern, noting that it had spread to over 117 countries, with more than 93,000 confirmed cases and 176 deaths.
 
Traditionally, Mpox has been associated with skin rashes and lesions. However, the 2022 outbreak revealed a broader spectrum of symptoms, particularly in the gastrointestinal tract. This article will delve into the study's findings on GI manifestations, which are often severe and can require multidisciplinary care.
 
Gastrointestinal Manifestations: What the Study Found
The study conducted a comprehensive review of existing literature on GI manifestations of Mpox, drawing from individual case reports and systematic reviews. Researchers identified a range of symptoms, from mild to severe, including nausea, vomiting, diarrhea, abdominal pain, and rectal bleeding. These symptoms, often mistaken for more common GI conditions like gastroenteritis or appendicitis, have complicated the diagnosis and treatment of Mpox.
 
Interestingly, the study found that while anorexia was the most commonly reported GI symptom, it was often overshadowed by more alarming symptoms like severe abdominal pain and diarrhea. These symptoms, the study suggests, may be early indicators of Mpox infection, especially in the prodromal stage, when patients are most contagious.
 
The Role of Sexual Transmission in GI Symptoms
The study also highlighted the role of sexual transmission especially for the clade 2b variant, particularly among men who have sex with men (MSM), in the development of GI symptoms. This group, which accounted for 96% of newly diagnosed cases, often presented with proctitis - an inflammation of the rectum that can cause severe pain and discomfort. In many cases, this was linked to anal intercourse, which facilitated the virus's entry into the rectal mucosa.
 
One of the study's most striking findings was the high prevalence of proctitis among Mpox patients. In a French study cited by the researchers, 45 out of 503 patients presented with proctitis, a condit ion that was previously thought to be rare. Another study by Spanish researchers also reported a significant number of cases, further emphasizing the need for healthcare providers to be aware of this manifestation.
 
Challenges in Diagnosis and Treatment
The study underscored the challenges in diagnosing and treating GI manifestations of Mpox. Given that these symptoms overlap with more common GI conditions, they are often misdiagnosed, leading to delays in appropriate treatment. Moreover, the study found that patients with GI symptoms were more likely to require hospitalization, particularly for pain management.
 
In severe cases, patients developed complications like rectal abscesses and perforations, which required surgical intervention. The study cited a case where a patient with an Mpox-related abscess underwent an incision and drainage procedure, highlighting the need for a multidisciplinary approach involving infectious disease specialists, colorectal surgeons, and gastroenterologists.
 
Current Treatment Options
Treatment of GI manifestations of Mpox remains largely supportive, focusing on symptom management. For mild cases, this includes hydration, pain relief, and topical treatments. However, the study noted that more severe cases often required antiviral therapy, such as Tecovirimat, which has shown promise in reducing symptoms and preventing complications.
 
Tecovirimat, an antiviral drug that inhibits viral replication, is currently being tested in clinical trials in the United States and the United Kingdom. These trials aim to determine the drug's efficacy in treating severe Mpox cases, particularly those involving GI symptoms. The study also mentioned other potential treatments, such as Brincidofovir and Cidofovir, though these are still under investigation.
 
The Importance of Multidisciplinary Care
One of the study's key takeaways was the importance of a multidisciplinary approach to managing GI manifestations of Mpox. Given the complexity of these symptoms and the potential for severe complications, healthcare providers must work together to ensure comprehensive care. This includes not only treating the symptoms but also addressing the underlying viral infection and any associated comorbidities.
 
The study also emphasized the need for ongoing research to better understand the pathophysiology of Mpox and its GI manifestations. As the virus continues to evolve, it is crucial that healthcare providers stay informed about the latest developments and treatment options.
 
Conclusion
Mpox, once thought to be a disease confined to skin manifestations, is now known to have significant gastrointestinal complications. The provides valuable insights into these manifestations, highlighting the need for increased awareness and multidisciplinary care.
 
As the global outbreak of Mpox continues to unfold, healthcare providers must be vigilant in recognizing and treating GI symptoms. By staying informed and adopting a comprehensive approach to care, they can help mitigate the impact of this emerging public health threat.
 
The study findings were published in the peer-reviewed journal: Current Infectious Disease Reports.
https://link.springer.com/article/10.1007/s11908-024-00845-9
 
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