Epidemiologic characteristics and clinical features of patients with monkeypox virus infection from a hospital in Peru between July and September 2022.

OBJECTIVES: Monkeypox (Mpox) recent outbreak has changed in terms of predominant transmission route and typical presentation. Describing current epidemiological and clinical characteristics is crucial to identifying cases and halting transmission. METHODS: An observational study was conducted at a Peruvian tertiary-level hospital and included all individuals with Mpox virus infection between July 01 and September 03, 2022. RESULTS: Among 205 confirmed cases, 99% (202/205) were men, 94% (192/205) were men who have sex with men or bisexual, and 66% (136/205) were living with HIV. Regarding sexual behavior, 87% (179/205) had a sexual encounter 21 days before consultation, although only 8% (17/205) identified sexual contact with a Mpox confirmed case; 65% (133/205) had sexual intercourse with casual partners, 55% (112/205) reported a last sexual partner unknown, and 21.5% (44/205) continued having sexual intercourse with symptoms. Systemic symptoms were fever (162/205, 79%), malaise (123/205, 60%), headache (119/205, 58%), fatigue (105/205, 52%), and lymphadenopathy (111/205, 54%). The distribution of skin lesions was generalized (166/205, 81%), located in the anogenital area (160/205, 78%), polymorphic (174/205, 85%), and it was the first symptom identified in 46% (94/205) of cases. Overall, 10% (21/205) required hospitalization, of whom 85.7% (18/205) have HIV infection. Complications included bacterial superinfection (n = 18), proctitis (n = 6), balanitis (n = 4), and necrosis of skin lesions (n = 3). CONCLUSION: In 2022, Mpox mainly affects men who have sex with men and People living with HIV/AIDS. It presents with skin lesions localized to the anogenital area and can lead to severe complications requiring hospitalization.

Insuficiencia respiratoria y hemoptisis en paciente con dengue: Hemorragia alveolar difusa como presentación inusual de dengue grave / Respiratory insufficiency and hemoptysis in a patient with dengue: Diffuse alveolar hemorrhage as an unusual presentation of severe dengue

Introducción: La infección por el virus del dengue es una enfermedad endémica en ciertas regiones del Perú. La mayoría de estos casos se clasifican como dengue sin signos de alarma y la mortalidad reportada es menor de 1%. Sin embargo, existen ciertas condiciones asociadas a la enfermedad que podrían incrementar la mortalidad. Reporte de caso: Se presenta el caso de una paciente mujer de 48 años procedente de área endémica de esta infección con cuadro clínico y hallazgos laboratoriales compatibles con enfermedad por dengue con signos de alarma. Durante la hospitalización, cursa con hemoptisis e insuficiencia respiratoria produciendo su posterior fallecimiento. Conclusión: Es importante reconocer la hemorragia alveolar difusa como parte del compromiso respiratorio por dengue y diferenciarlo de otras posibilidades infecciosas y no infecciosas para poder brindar el manejo adecuado de forma temprana.

Background: Dengue virus infection is an endemic disease in some regions of Peru. Most of these cases are classified as dengue without warning signs and the reported mortality is less than 1%. However, there are certain conditions associated with the disease that could increase mortality. We Case report:present the case of a 48-year-old female patient from a dengue endemic area with clinical and laboratory compatible with dengue disease with warning signs. During hospitalization, she presents hemoptysis and respiratory insufficiency, leading to death. It is important to recognize diffuse alveolar Conclusion:hemorrhage as part of dengue respiratory manifestations and to differentiate it from other infectious and non-infectious possibilities in order to provide appropriate and early management.