Evidence map›Paper›PMID 36684566›Full record

ArticleFrontiers in cardiovascular medicine2022

Case report: From monkeypox pharyngitis to myopericarditis and atypical skin lesions.

María Ascensión Sanromán Guerrero, Elena Hernández Sánchez, Belén de Nicolás Ruanes, Pablo Fernández-González, Sonia Antoñana Ugalde, Alejandra González Leal, Marcelo Sanmartín Fernández, Jose Javier Alarcón Rodríguez, Laura Martinez Garcia, Rosa Escudero and 4 more

Open access · goldAbstract readCase Reports
In one paragraph

Article in Frontiers in cardiovascular medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.7field-weighted citation impact, top 34% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 5 citations in OpenAlex.

  1. Review
  2. Review
  3. Cardiac Involvement in Monkeypox Outbreak.Discoveries (Craiova, Romania)
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors at 3 institutions in 1 country.

María Ascensión Sanromán GuerreroDepartment of Cardiology Medicine, Hospital Ramón y Cajal, Madrid, Spain.
Elena Hernández SánchezDepartment of Cardiology Medicine, Hospital Ramón y Cajal, Madrid, Spain.
Belén de Nicolás RuanesDepartment of Dermatology, Hospital Ramón y Cajal, Madrid, Spain.
Pablo Fernández-GonzálezDepartment of Dermatology, Hospital Ramón y Cajal, Madrid, Spain.
Sonia Antoñana UgaldeDepartment of Cardiology Medicine, Hospital Ramón y Cajal, Madrid, Spain.
Alejandra González LealDepartment of Cardiology Medicine, Hospital Ramón y Cajal, Madrid, Spain.
Marcelo Sanmartín FernándezDepartment of Cardiology Medicine, Hospital Ramón y Cajal, Madrid, Spain.
Jose Javier Alarcón RodríguezDepartment of Radiology, University Hospital Ramón y Cajal, Madrid, Spain.
Laura Martinez GarciaDepartment of Microbiology, University Hospital Ramón y Cajal and IRYCIS, Universidad de Alcalá, CIBERESP, Madrid, Spain.
Rosa EscuderoDepartment of Infectious Diseases, University Hospital Ramón y Cajal and IRYCIS, Universidad de Alcalá, CIBERINFEC, Madrid, Spain.
Maria Ángeles Fernández MéndezDepartment of Radiology, University Hospital Ramón y Cajal, Madrid, Spain.
Jose Luis Zamorano GómezDepartment of Cardiology Medicine, Hospital Ramón y Cajal, Madrid, Spain.
Beatriz Montero LlorenteDepartment of Clinical Pharmacology, Hospital Ramón y Cajal, Madrid, Spain.
Maria Jesús Vivancos-GallegoDepartment of Infectious Diseases, University Hospital Ramón y Cajal and IRYCIS, Universidad de Alcalá, CIBERINFEC, Madrid, Spain.
Hospital Universitario Ramón y Cajal · ESUniversidad de Alcalá · ESInstituto Ramón y Cajal de Investigación Sanitaria · ES

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: A global outbreak of the human monkeypox virus (HMPXV), first identified in May 2022, was declared a health emergency of international concern on 23 July 2022. Before the global outbreak, monkeypox cases were mostly confined to central and west African countries, where this virus is prevalent. Close contact, mainly sexual contact, is supposed to be the main route of transmission, and it is remarkable that the incidence is higher in men who have sexual relationships with other men. Case summary: A 40-year-old Caucasian man arrived at the emergency department complaining of oppressive epigastric pain extending to the chest after a diagnosis of pharyngitis, which was suspected to be caused by the human monkeypox virus. Based on the clinical symptoms, physical examination, serum cardiac biomarkers, and electrocardiographic findings, he was diagnosed with myopericarditis. The real-time PCR for human monkeypox in skin lesions, urine, plasma, and the oropharyngeal swab was positive. The peak of troponin I was 20.6 ng/ml, and the electrocardiogram showed an upward concavity in the ST segment in diffuse leads, which was in agreement with the previous diagnosis. The presence of edema, subepicardial, and myocardial late gadolinium enhancement, and increased values on T1 mapping in the cardiac MRI were in agreement with the diagnosis of myopericarditis. Antiviral treatment with tecovirimat was started with excellent tolerability. After 6 days, the patient recovered and was discharged. Discussion: To our knowledge, this is one of the first reported cases of myopericarditis due to human monkeypox infection, which was confirmed by a cardiac MRI following modified Lake Louise criteria. The short span between the onset of the mucocutaneous symptoms and the myocardial damage suggests a pathogenic association. Furthermore, the active viral replication in plasma samples and the negative results on real-time PCR for other viruses support this clinical association.

Indexed as

Lake Louise criteriamonkeypoxmyocarditispericarditisplasmatecovirimat

Identifiers

PMID36684566
PMCPMC9851183
OpenAlexW4313554950

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.