Mpox (formerly monkeypox) has emerged as an infection in the context of sexually transmitted infections (STIs), particularly among vulnerable populations. Specialized STI services play a crucial role in the early identification and management of cases. To describe the clinical-epidemiological profile of the first mpox cases seen in an STI clinic, with emphasis on clinical manifestations, coinfections and management strategies. Retrospective descriptive study based on the analysis of 168 suspected mpox cases seen between May and December 2022. Diagnosis was confirmed by real-time polymerase chain reaction (PCR), performed on material collected from skin lesions and crusts. Sociodemographic, clinical, behavioral and laboratory variables were analyzed, with emphasis on STI coinfections and use of prophylaxis. Of the 168 suspected cases, 131 (77.9%) were confirmed as mpox. Most confirmed cases were male (n=93), predominantly aged 30–39 years. One hundred and six reported having sex with men, and 59 reported 2 to 5 partners in the three weeks prior. The most common clinical manifestations were lymphadenopathy (n=106), hyperthermia and headache/asthenia. Skin lesions included papules (n=79), vesicles (n=73) and crusts (n=65), predominantly located in the genital region (n=104) and on the face (n=25). The main associated diagnosis was recent latent syphilis, observed in both groups (confirmed and discarded). The treponemal test was reactive in 52 of the confirmed cases and 10 of the discarded cases. In 100% of cases with active or recent latent syphilis, benzathine penicillin 2,400,000 IU was administered. HIV coinfection was identified in 49.5% of confirmed cases and 26.9% of discarded cases. In both groups, 28.0% were people living with HIV and 44.6% were users of HIV pre-exposure prophylaxis (PrEP). Mpox predominantly affected men who have sex with men, with a high frequency of STI coinfections, especially syphilis and HIV. The predominance of recent latent syphilis reinforces the importance of syndromic management and expanded testing. The role of specialized units is central to surveillance, early diagnosis and integrated control of these infections.
Grandi et al. (2026) studied this question.