ReviewThe Lancet. Infectious diseases2023
Novel severe oculocutaneous manifestations of human monkeypox virus infection and their historical analogues.
Review in The Lancet. Infectious diseases, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 1 of them a synthesis that pooled it.
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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.
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.
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Who cites it
21 citing papers in PubMed, 1 synthesis or guideline pooled it, 44 citations in OpenAlex.
- The impact of immunosuppression on the mortality and hospitalization of Monkeypox: a systematic review and meta-analysis of the 2022 outbreak.Virology journal · 2024Pooled it
- Monkeypox-Associated Genital Necrosis in an Immunocompromised Patient: Case Report and Literature Review of Genital Mpox Reconstruction.Archives of plastic surgery · 2026Article
- Antifolate agent aminopterin demonstrates potent anti-monkeypox virus activityMicrobiology spectrum · 2026Article
- Monkeypox virus protein OPG188 antagonizes cGAS-STING antiviral signaling pathway to mediate immune evasion.Proceedings of the National Academy of Sciences of the United States of America · 2026Article
- Ocular manifestations in a cohort of patients with mpox in the Democratic Republic of the Congo 2007-2011.ASM case reports · 2026Article
- Article
- Development and validation of a new mpox virus sequencing and bioinformatic analysis pipeline.Emerging microbes & infections · 2025Article
- Ocular Manifestations of Mpox and Other Poxvirus Infections: Clinical Insights and Emerging Therapeutic and Preventive Strategies.Vaccines · 2025Review
- Complete Genome Sequence Analysis of the First Imported Mpox Virus Clade Ib Variant in China.Pathogens (Basel, Switzerland) · 2025Article
- Mpox: a public health emergency demands, urgent action.Annals of medicine and surgery (2012) · 2025Article
- Review
- Immune Reconstitution Inflammatory Syndrome Related to Antiretroviral Therapy Initiation in People With HIV and Mpox: An Observational Retrospective Study.Open forum infectious diseases · 2024Article
- Swinepox virus: an unusual outbreak in free-range pig farms in Sicily (Italy).Porcine health management · 2024Article
- Severe Mpox Among People With Advanced Human Immunodeficiency Virus Receiving Prolonged Tecovirimat in New York City.Open forum infectious diseases · 2024Article
- A Case of Sustained Viral Shedding of Mpox With Ocular Involvement Resulting in Vision Loss.Open forum infectious diseases · 2024Article
- Mpox (formerly monkeypox): pathogenesis, prevention, and treatment.Signal transduction and targeted therapy · 2023Review
- Review
- Spectrum of ophthalmic manifestations in monkeypox virus infection worldwide: Systematic review and meta-analysis.Heliyon · 2023Review
- Fatal Case of Progressive Mpox in a Patient with AIDS-Viral Enteropathy and Malabsorption Demanding the Use of Full Parenteral ARV and Endovenous Cidofovir.Infectious disease reports · 2023Article
- Emergency department approach to monkeypox.World journal of emergency medicine · 2023Review
Corrections and comments
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Authors and funding
8 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
WHO has declared human mpox (formerly known as monkeypox) a global public health emergency since July, 2022. When case numbers were increasing, so did clinicians' exposures to new elements of the disease. Additionally, the burden of mpox is particularly apparent in immunocompromised patients, who can have more variable and severe manifestations of disease across organ systems. In this Grand Round, we report novel and severe oculocutaneous manifestations of mpox in this population, which are both sight and life threatening. Specifically, we highlight two patients with mpox and AIDS who had refractory skin necrosis that progressed to either ocular compromise or panfacial gangrene, or both. Both patients ultimately died due to systemic complications of their infections. Through clinical analogies, we show how past experiences with related orthopoxviruses, such as variola virus (smallpox) and vaccinia virus, can add useful context for understanding and treating these new disease states. We suspect that in patients who are immunocompromised, monkeypox virus can clinically evolve not only via viraemia but also through direct intradermal spread. We propose that intradermal spread occurs by a process clinically and immunologically analogous to progressive vaccinia, a complication previously seen after conventional smallpox vaccination. We share evidence in support of this theory and implications regarding early management and post-exposure prophylaxis for at-risk populations. Content note: this Grand Round contains graphic images of mpox lesions of the eyes and face.
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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.