A case series of patients with ophthalmic manifestations of monkeypox in Spain

Abstract

Monkeypox virus (MPXV) is a zoonotic orthopox DNA virus presently causing a global outbreak. The mucosae are affected in 41% of the cases; the nasal and eye regions are the least affected (1%). The most frequent eye infection is conjunctivitis with severe cases of corneal affection leading to permanent visual sequelae. We describe two cases of patients presenting facial edema, erythema, and vesiculo-pustular lesions with confirmed positive MPXV DNA polymerase chain reaction (PCR). Preseptal cellulitis and MPXV infection were diagnosed and treated with antibiotics and tecovirimat. A third patient was admitted to the hospital with pain and redness of the right eye and vesiculo-pustular skin lesions. On ophthalmological examination, he was diagnosed with a corneal ulcer and a creamy white infiltrate and was treated with systemic tecovirimat and ciprofloxacin eye drops. Healthcare professionals should be familiar with ocular manifestations of MPXV infection and consult ophthalmologists to reduce the risk of potentially vision-threatening complications.