With currently 1790 reported cases, Germany is a monkeypox hotspot. In order to stop the further spread of the virus, it is necessary to diagnose and treat the infection quickly. A possible early sign of the disease is now presented.

In the early stages, monkeypox infection is difficult to diagnose. In addition, the incubation period is between 5 and 21 days. Physicians at the University Hospital in Bonn are therefore reporting a case that indicates an early symptom of an infection with the monkeypox virus. In “Deutsches Ärzteblatt”, Stefan Schlabe and Christoph Boesecke present the medical history of a patient who initially presented to the general practitioner because of a new blister in the corner of the mouth. The 51-year-old is an HIV patient who has been well adjusted to antiretroviral therapy for years.

The man, who otherwise showed no other signs of illness, was first prescribed an ointment and sent home. But this did not help and just a few days later the blisters turned into a so-called corner of the mouth ulcer, i.e. a painful ulcer in the corner of the mouth. The patient therefore went back to his family doctor, who took a smear test from the ulcer and sent it to a laboratory for examination. There, monkeypox viruses were detected using the so-called polymerase chain reaction (PCR).

The infected patient then developed further symptoms. The typical monkeypox blisters formed on the skin and in the mouth. The blisters continued to increase in the area of ??the palate. The blisters became so numerous that the base of the tongue swelled and the patient could no longer speak properly. He then had to be admitted to the University Hospital in Bonn, where antiviral therapy was also started. As a result, the man recovered quickly and was discharged from the hospital after just four days.

The first case of monkeypox infection in Germany was discovered on May 19, 2022. According to the report, the Robert Koch Institute is currently registering 1,790 proven infections with monkeypox in the country. The World Health Organization has counted more than 6,000 cases so far. The publication of the case is intended to sensitize doctors to consider an infection with monkeypox viruses as early as possible in the future in the case of ulcers in the corners of the mouth. Patients could also benefit from this knowledge.

(This article was first published on Friday, July 15, 2022.)