A healthy 37-year-old woman presented with a 4-day history of painless but pruritic genital rash and a 2-day history of fever and myalgias. Two weeks earlier, she had condomless intercourse with a new male partner. Physical examination revealed several umbilicated pustules limited to the genital area (Figure ). Polymerase chain reaction assays of the swabs obtained were positive for monkeypox virus. Although classic cases of monkeypox included a febrile prodrome followed by generalized rash, the current outbreak has been characterized mainly by painless anogenital lesions, often without a prodrome. Most reported cases are being observed in men who have sex with men, but this case raises awareness that women are also at risk, and gynecologists must be alert to correctly identify the genital lesions and promptly implement isolation measures. Moreover, the localized genital lesions increase speculation about sexual transmission being primarily involved in the current outbreak.
Figure.
Umbilicated pustules in the female genital area in monkeypox virus infection
Portela-Dias. Monkeypox infection with localized genital lesions in women. Am J Obstet Gynecol 2022.
Footnotes
The authors report no conflict of interest.
No funding sources were involved in the study.