Acute respiratory distress syndrome due to monkeypox virus
  • Tona Tchoubou
    Intensive Care Unit, Delafontaine Hospital, Saint-Denis, France
  • Rima El-Hosni
    Pulmonology and Infectious Diseases Department, Delafontaine Hospital, Saint-Denis, France
  • Marion Dollat
    Infectious Diseases Department, Delafontaine Hospital, Saint-Denis, France
  • Pierre Jaquet
    Intensive Care Unit, Delafontaine Hospital, Saint-Denis, France
  • Celine Tournus
    Microbiology Department, Delafontaine Hospital, Saint-Denis, France
  • Yacine Tandjaoui-Lambiotte
    Pulmonology and Infectious Diseases Department, Delafontaine Hospital, Saint-Denis, France; INSERM U1272 Hypoxia and the Lung, 93000; INSERM UMR 1137 IAME, Paris, France
  • Daniel Da Silva
    Intensive Care Unit, Delafontaine Hospital, Saint-Denis, France

Keywords

Monkeypox virus, ARDS, viraemia, tecovirimat, skin rash

Abstract

We report the first case of monkeypox virus (MPXV) associated acute respiratory distress syndrome (ARDS). A 34-year-old French woman with no medical history was admitted to the intensive care unit (ICU) for fever, altered mental status, hypotension and hypoxaemia. She presented with a diffuse skin rash with vesiculopustular lesions involving the four limbs and perineal ulcers with a skin swab positive for MPXV. On day 2, the patient presented moderate ARDS requiring invasive mechanical ventilation. She also had pleural empyema due to Streptococcus pyogenes. MPXV PCR was positive in the bronchoalveolar lavage, the pleural effusion and the blood. The patient was treated with tecovirimat. Despite the treatment, she had persistent viraemia for at least ten days. The patient condition rapidly improved; she was weaned from mechanical ventilation on day 18 despite the persistence of radiological lung opacities. She fully recovered and was discharged home on day 38 after admission.

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References

  • Beaumont AL, Peiffer-Smadja N. Mpox: a new name for a new disease? Lancet Infect Dis 2022;23:516–517.
  • Centers for Disease Control and Prevention. 2022–2023 global map & case count. Published 17 January 2023. Accessed 23 January 2023. https://www.cdc.gov/poxvirus/monkeypox/response/2022/world-map.html
  • Mailhe M, Beaumont AL, Thy M, Le Pluart D, Perrineau S, Hou-Hou-Fidouh N, et al. Clinical characteristics of ambulatory and hospitalised patients with monkeypox virus infection: an observational cohort study. Clin Microbiol Infect 2022;29:233–239.
  • 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. N Engl J Med 2022;387:679–691.
  • Benites-Zapata VA, Ulloque-Badaracco JR, Alarcon-Braga EA, Hernandez-Bustamante EA, Mosquera-Rojas MD, Bonilla-Aldana DK, et al. Clinical features, hospitalisation and deaths associated with monkeypox: a systematic review and meta-analysis. Ann Clin Microbiol Antimicrob 2022;21:36.
  • Ogoina D, Iroezindu M, James HI, Oladokun R, Yinka-Ogunleye A, Wakama P, et al. Clinical course and outcome of human monkeypox in Nigeria. Clin Infect Dis 2020;71:e210–e214.
  • Huhn GD, Bauer AM, Yorita K, Graham MB, Sejvar J, Likos A, et al. Clinical characteristics of human monkeypox, and risk factors for severe disease. Clin Infect Dis 2005;41:1742–1751.
  • Gessain A, Nakoune E, Yazdanpanah Y. Monkeypox. N Engl J Med 2022;387:1783–1793.
  • Li Y, Zhao H, Wilkins K, Hughes C, Damon IK. Real-time PCR assays for the specific detection of monkeypox virus West African and Congo Basin strain DNA. J Virol Methods 2010;169:223–227.
  • ARDS Definition Task Force; Ranieri VM, Rubenfeld GD, Taylor Thompson B, Fergusin ND, Caldwell W, Fan E, et al. Acute respiratory distress syndrome: the Berlin Definition. JAMA. 2012;307:2526–2533.
  • Siegrist EA, Sassine J. Antivirals with activity against monkeypox: a clinically oriented review. Clin Infect Dis 2023;76:155–164.
  • Desai AN, Thompson GR 3rd, Neumeister SM, Arutyunova AM, Trigg K, Cohen SH. Compassionate use of tecovirimat for the treatment of monkeypox infection. JAMA. 2022;328:1348–1350.
  • Fink DL, Callaby H, Luintel A, Beynon W, Bond H, Lim EY, et al. Clinical features and management of individuals admitted to hospital with monkeypox and associated complications across the UK: a retrospective cohort study. Lancet Infect Dis 2022;23:589–597.
  • Jezek Z, Szczeniowski M, Paluku KM, Mutombo M. Human monkeypox: clinical features of 282 patients. J Infect Dis 1987;156:293–298.
  • Yinka-Ogunleye A, Aruna O, Dalhat M, Ogoina D, McCollum A, Disu Y, et al. Outbreak of human monkeypox in Nigeria in 2017–18: a clinical and epidemiological report. 2019;19:872–979.
  • Adler H, Gould S, Hine P, Snell LB, Wong W, Houlihan CF, et al. Clinical features and management of human monkeypox: a retrospective observational study in the UK. Lancet Infect Dis 2022;22:1153–1162.
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    Published: 2023-10-19
    Issue: 2023: Vol 10 No 11 (view)


    How to cite:
    1.
    Tchoubou T, El-Hosni R, Dollat M, Jaquet P, Tournus C, Tandjaoui-Lambiotte Y, Da Silva D. Acute respiratory distress syndrome due to monkeypox virus. EJCRIM 2023;10 doi:10.12890/2023_004126.