C9 (Clinical Case) Monkeypox Virus Infection in a 2-Month-Old Infant
Notice bibliographique
Résumé
Abstract Introduction/Background The 2022 Monkeypox virus outbreak shed attention on an illness that is rare in non-endemic countries. Children are at risk of severe disease based on case series from previous outbreaks. Tecovirimat may be considered as a therapy in young children. Its efficacy and safety profile, however, have never been formally studied. This case report presents the first laboratory-confirmed case of monkeypox virus infection in a Canadian infant and its management. Case Description A 2-month-old infant presented to an emergency department with a vesiculopustular skin rash. A week before, parents noticed an eruptive cluster of 3 fluid-filled vesicles on the infant’s forehead. In the next days, vesiculopustular lesions appeared on his body. One spike of temperature was reported with no other sign of illness. On physical examination, a dozen umbilicated well-circumscribed vesico-pustules were observed with minimal skin inflammation. They ranged from 2 to 5 mm in size and were scattered over the face, trunk and limbs including palms and soles. In addition, 3 confluent crusted umbilicated lesions were present on the forehead. Discussion Differential diagnosis included varicella zoster virus, herpes simplex virus, and enteroviral infections. Empiric intravenous acyclovir was initiated pending specimen analysis. Bacterial culture and viral PCRs were negative on CSF and skin specimens. Due to transmission of monkeypox in the local adult population, orthopoxvirus was tested by PCR. The result was positive on a skin specimen and was later confirmed by the National Microbiology Laboratory of Canada. Because of the patient’s age and ongoing new lesions, tecovirimat was initiated. After 24 hours, new lesions stopped appearing and regression and crusting of active lesions were noted. Treatment was continued for 14 days without adverse events. Although parents denied similar symptoms, an epidemiological link was postulated, given work exposure in a setting with high risk of transmission in one of them. This case adds insight on the clinical features, the course of disease and management in infants. This 2-month-old infant did not develop any complication from the illness and was among the youngest patients with monkeypox to be treated with tecovirimat. Conclusion As monkeypox infection remains rare in children and may convey a higher risk for severe disease, a high degree of suspicion is warranted for clinicians caring for children. Monkeypox should be included in the differential diagnosis of an unexplained vesiculopustular rash. Finally, tecovirimat as a treatment for monkeypox infection in children was shown here to be safe and effective, even when started late in the evolution.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,002 | 0,001 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,002 | 0,001 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,004 | 0,003 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».