An indigenous monkeypox (Mpox) case in a non-endemic region: a case report.

Introduction and importance: Mpox, a zoonotic viral infection caused by the Monkeypox virus, has recently emerged as a global public health concern. Mpox cases are increasingly being reported in non-endemic regions. In this manuscript, we report an indigenous case of Mpox in a non-endemic region with unusual clinical presentation. Case presentation: A 32-year-old female, residing in District Khyber, presented with a 4-day history of fever, fatigue, myalgia, sore throat, body rashes, oral and nasopharyngeal lesions, and widespread vesiculopustular eruptions. She was diagnosed with monkeypox on 21 February 2025. Her husband recently returned from Saudi Arabia, and was suspected to be the primary source of infection. The patient had no history of animal contact, recent vaccination or immunocompromising conditions. Clinical discussion: The patient was isolated at a tertiary care hospital, and a multidisciplinary public health response was initiated. The patient received supportive treatment, including antipyretics, analgesics, and fluid management. Infection prevention, and control measures were taken. The patient gradually improved and resulted in complete resolution of symptoms in three weeks. Conclusion: Indigenous cases of Mpox are an emerging challenge. Early identification, accurate diagnosis, and supportive care are crucial to reduce mortality and prevent outbreak.