Monkeypox infection with localized genital lesions in women

Abstract

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.