Vulvar mpox lesions in a heterosexual cisgender woman with molecular biology and electron microscopy findings: case report

Mauro Romero Leal Passos; Wilma Nancy Campos Arze; Izabel Christina Nunes de Palmer Paixão; Claudio Cesar Cirne dos Santos Pessanha; Caroline de Souza Barros; Kíssila Rabelo; Jorge José de Carvalho; Renata de Queiroz Varella; Carolina Varella Leal Passos; Paula Varella Leal Passos; Christina Thereza Machado Bittar

doi:10.5327/DST-2177-8264-1471

Authors

Mauro Romero Leal Passos Universidade Federal Fluminense – Niterói (RJ), Brazil. https://orcid.org/0000-0002-6183-7985
Wilma Nancy Campos Arze Universidade Federal de Integração Latino-Americana – Foz do Iguaçu (PR), Brazil. https://orcid.org/0000-0002-2620-0620
Izabel Christina Nunes de Palmer Paixão Universidade Federal Fluminense – Niterói (RJ), Brazil. https://orcid.org/0000-0001-7513-2567
Claudio Cesar Cirne dos Santos Pessanha Universidade Federal Fluminense – Niterói (RJ), Brazil. https://orcid.org/0000-0001-8376-1830
Caroline de Souza Barros Universidade Federal Fluminense – Niterói (RJ), Brazil. https://orcid.org/0000-0002-4678-3093
Kíssila Rabelo Universidade Estadual do Rio de Janeiro – Rio de Janeiro (RJ), Brazil. https://orcid.org/0000-0001-7579-7788
Jorge José de Carvalho Universidade Estadual do Rio de Janeiro – Rio de Janeiro (RJ), Brazil. https://orcid.org/0000-0002-9426-6381
Renata de Queiroz Varella Secretaria de Saúde de Piraí – Rio de Janeiro (RJ), Brazil. https://orcid.org/0009-0008-7221-2252
Carolina Varella Leal Passos Universidade de Vassouras – Vassouras (RJ), Brazil. https://orcid.org/0000-0003-3124-1774
Paula Varella Leal Passos Secretaria de Saúde de Piraí – Rio de Janeiro (RJ), Brazil. https://orcid.org/0000-0002-3806-6289
Christina Thereza Machado Bittar Laboratório Bittar – Niterói (RJ), Brazil. https://orcid.org/0000-0003-2839-9677

DOI:

https://doi.org/10.5327/DST-2177-8264-1471

Keywords:

Mpox, Monkeypox, Women, Vulvar lesions, Molecular diagnosis, Electron microscopy, Sexually transmitted diseases

Abstract

Introduction: Mpox, an emerging viral zoonosis, caused a global outbreak in 2022, exhibiting patterns of interpersonal transmission distinct from those observed in previous outbreaks. While the initial focus was on transmission among men who have sex with men, the occurrence and clinical characteristics of mpox in women remain poorly understood. Objective: To describe a case of vulvar lesions in a heterosexual cisgender woman diagnosed with mpox. Methods: This is the case of a heterosexual cisgender woman with vulvar lesions confirmed as mpox, who was treated at the Sexually Transmitted Diseases Sector of the Fluminense Federal University. Results: A 29-year-old cisgender heterosexual woman presented with vulvar lesions confirmed as mpox. The patient reported a history of attending crowded places in the period before the onset of lesions. Diagnostic confirmation was achieved by molecular biology (real-time polymerase chain reaction) and electron microscopy. Conclusion: This case highlights the importance of considering mpox in the differential diagnosis of genital lesions in women and reinforces the need for a comprehensive approach to the surveillance and understanding of the disease's epidemiology across diverse populations.

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References

Centers for Disease Control and Prevention. Monkeypox cases by age and gender, race/ethnicity, and symptoms [Internet]. 2022 [cited on 2024 Apr 12]. Available from: https://www.cdc.gov/poxvirus/monkeypox/response/2022/demographics.html

Karagoz A, Tombuloglu H, Alsaeed M, Tombuloglu G, AlRubaish AA, Mahmoud A, et al. Monkeypox (mpox) virus: classification, origin, transmission, genome organization, antiviral drugs, and molecular diagnosis. J Infect Public Health. 2023;16(4):531-41. https://doi.org/10.1016/j.jiph.2023.02.003

World Health Organization. Mpox [Internet]. Geneva: WHO; 2024 [cited on 2024 Apr 12]. Available from: https://www.who.int/news-room/fact-sheets/detail/mpox

Bunge EM, Hoet B, Chen L, Lienert F, Weidenthaler H, Baer LR, et al. The changing epidemiology of human monkeypox–a potential threat? A systematic review. PLoS Negl Trop Dis. 2022;16(2):e0010141. https://doi.org/10.1371/journal.pntd.0010141

Joshi MN, Vadher BK, Dudani AB. Mpox virus infection in women and outbreak sex disparities. Int J Infect Dis. 2024;124:123-8.

Pan American Health Organization. Epidemiological update of monkeypox in women. Washington: PAHO; 2022.

Pereira PLG, Flores ERM, Silva TPR, Faria APV, Ribeiro EEN, Sato APS, et al. Epidemiologia das notificações de monkeypox no estado de Minas Gerais, Brasil. Rev Bras Enferm. 2023;76(3):e20220598. https://doi.org/10.1590/0034-7167-2022-0598pt

Madewell ZJ, Charniga K, Masters NB, Asher J, Fahrenwald L, Still W, et al. Serial Interval and Incubation Period Estimates of Monkeypox Virus Infection in 12 Jurisdictions, United States, May-August 2022. Emerg Infect Dis. 2023;29(4):818-21. https://doi.org/10.3201/eid2904.221622

Patel A, Bilinska J, Tam JCH, Fontoura DS, Mason CY, Daunt A, et al. Clinical features and novel presentations of human monkeypox in a central London centre during the 2022 outbreak: descriptive case series. BMJ. 2022;378:e072410. https://doi.org/10.1136/bmj-2022-072410

Petersen E, Abubakar I, Ihekweazu C, Heymann D, Ntoumi F, Blumberg L, et al. Monkeypox–enhancing public health preparedness for an emerging lethal human zoonotic epidemic threat in the wake of the smallpox post-eradication era. Int J Infect Dis. 2019;78:78-84. https://doi.org/10.1016/j.ijid.2018.11.008

Thornhill JP, Barkati S, Walmsley S, Rockstroh J, Antinori A, Harrison LB, et al. Monkeypox virus infection in humans across 16 countries – April–June 2022;387(8):679-91. N Engl J Med. 2022;387(8):679-91. https://doi.org/10.1056/NEJMoa2207323

Alshamrani MM, El-Saed A, Al-Fayez S, AlAmeer K, Al Zunitan M, Abalkhail M, et al. Routes of transmission of mpox by virus clade and geographic distribution: a systematic review. J Infect Public Health. 2025;18(12):102985. https://doi.org/10.1016/j.jiph.2025.102985

Li Y, Olson VA, Laue T, Laker MT, Damon IK. Detection of monkeypox virus with real-time PCR assays. J Clin Virol. 2022;58(2):194-203. https://doi.org/10.1016/j.jcv.2006.03.012

Reed KD, Melski JW, Graham MB, Regnery RL, Sotir MJ, Wegner MV, et al. The detection of monkeypox in humans in the Western Hemisphere. N Engl J Med. 2004;350(4):342-50. https://doi.org/10.1056/NEJMoa032299

Karagoz A, Tombuloglu H, Alsaeed M, Tombuloglu G, AlRubaish AA, Mahmoud A, et al. Monkeypox (mpox) virus: classification, origin, transmission, genome organization, antiviral drugs, and molecular diagnosis. J Infect Public Health. 2023;16(4):531-41. https://doi.org/10.1016/j.jiph.2023.02.003

Gagnier JJ, Kienle G, Altman DG, Moher D, Sox H, Riley D, et al. The CARE guidelines: consensus-based clinical case reporting guideline development. Glob Adv Health Med. 2013;2(5):38-43. https://doi.org/10.7453/gahmj.2013.008

Agência Nacional de Vigilância Sanitária. Nota técnica GVIMS/GGTES/ANVISA no 03/2022. Orientações para prevenção e controle da monkeypox nos serviços de saúde [Internet]. Brasília: ANVISA; 2022 [cited on 2025 June 05]. Available from: https://www.gov.br/anvisa/pt-br/centraisdeconteudo/publicacoes/servicosdesaude/notas-tecnicas/2020/nota-tecnica-gvims-ggtes-anvisa-no-03-2022-orientacoes-para-prevencao-e-controle-da-monkeypox-nos-servicos-de-saude

Satapathy P, Khatib MN, Gaidhane S, Zahiruddin QS, Alrasheed HA, Al-Subaie MF, et al. Multi-organ clinical manifestations of Mpox: an umbrella review of systematic reviews. BMC Infect Dis. 2024;24:992. https://doi.org/10.1186/s12879-024-09884-y

Arze WNC. Mpox em pacientes atendidos no Setor de Doenças Sexualmente Transmissíveis da Universidade Federal Fluminense no município de Niterói, RJ, Brasil. [tese]. Niterói: Universidade Federal Fluminense; 2024.

Vulvar mpox lesions in a heterosexual cisgender woman with molecular biology and electron microscopy findings: case report

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