猴痘4例及文献复习

4 cases of monkeypox and literature review

目的了解猴痘的病原学特征、传播途径、临床表现、检测及诊断方法,为猴痘的防治防控提供依据。方法对沈阳市第六人民医院2023年6-7月收治的4例猴痘患者的流行病学史、临床表现、实验室检查等资料进行分析,并对国内外报道相关病例资料进行回顾。结果4例病例均为男男性接触人群(MSM),近21d密切接触人员中无猴痘发病人员。发病后主要症状为生殖器、肛周、面部及躯干部的皮疹,早期为斑丘疹,逐渐演变为水疱疹、脓疱疹,直至结痂。4例病例皮损部位、血液、咽拭子标本猴痘病毒核酸检测阳性,病例1经基因测序结果为Ⅱb B.1.3(西非进化支)。4例病例经治疗后均达到出院标准后出院。结论猴痘在我国目前仍属于新发传染病,根据接触史、临床表现及核酸检测结果可作出诊断。应提高临床医生对猴痘患者的皮疹识别,尤其在MSM中对皮疹患者开展猴痘核酸检测。

Objective To understand the etiological characteristics,transmission route,clinical manifestations,detection and diagnosis methods of monkeypox,and provide the basis for the prevention and control of monkeypox.Method The epidemiological history,clinical manifestations and laboratory examination of 4 monkeypox patients admitted to Shenyang Sixth People's Hospital were analyzed,and the relevant case data reported at home and abroad were reviewed.Result All the 4 cases were men who have sex with men(MSM)population,and no monkeypox patients had been in close contact in the past 21 days.The main symptoms after the onset were rashes on genitals,perianal,face,and trunk,which were maculopapular in the early stage and gradually evolved into water herpes and pustular rash until scabs.Monkeypox virus nucleic acid test was positive in skin lesions,blood samples and throat swabs of 4 cases,and case 1 was found to beⅡb B.1.3(West African clades)by gene sequencing.After treatment,all the 4 cases were discharged after meeting the discharge standard.Conclusion Monkeypox is still a newly emerging infectious disease in China,which can be diagnosed according to exposure history,clinical manifestations and nucleic acid test results.The rash recognition of monkeypox patients by clinicians should be improved,especially monkeypox nucleic acid testing in patients with rash in MSM population.