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What are the key clinical features to consider when diagnosing Mpox in a primary care setting?
Answer
When diagnosing Mpox in a primary care setting, key clinical features to consider include an initial prodromal phase characterized by fever, malaise, headache, and lymphadenopathy, which is a distinguishing feature from other similar infections 1. Following this, a characteristic rash typically develops, progressing through macular, papular, vesicular, and pustular stages before crusting and healing. The rash often begins on the face and then spreads centrifugally to the trunk, limbs, and sometimes the palms and soles 1. Lymphadenopathy, particularly in the cervical, axillary, or inguinal regions, is a prominent and early sign that helps differentiate Mpox from chickenpox or smallpox 1. In addition, recent literature highlights that lesions may be painful and can involve mucosal surfaces, including the oral cavity and genitalia, which is important to note in clinical assessment (Dashraath et al., 2022). The presence of systemic symptoms such as fever and lymphadenopathy preceding the rash, combined with the characteristic lesion progression and distribution, should raise suspicion of Mpox in patients presenting in primary care, especially if there is relevant epidemiological exposure or travel history 1 (Dashraath et al., 2022).
Key References
- NG206 - Myalgic encephalomyelitis (or encephalopathy)/chronic fatigue syndrome: diagnosis and management
- NG237 - Suspected acute respiratory infection in over 16s: assessment at first presentation and initial management
- NG143 - Fever in under 5s: assessment and initial management
- (Dashraath et al., 2022): Monkeypox in pregnancy: virology, clinical presentation, and obstetric management.
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