Chest X-ray findings in Mpox patients and the correlation between cycle threshold of Real-time PCR for Mpox relative to pneumonia and death in Bamrasnaradura Infectious Disease Institute

Authors

  • Parichut Vongthawatchai ฺBamrasnaradura Infectious Diseases Institute, Department of Disease Control
  • Panyaros Kongpanya Bamrasnaradura Infectious Disease Institute, Department of Disease Control
  • Natcha Nateniyom Bamrasnaradura Infectious Disease Institute, Department of Disease Control

DOI:

https://doi.org/10.14456/dcj.2024.33

Keywords:

Mpox, pneumonia, chest radiogragh

Abstract

Mpox is an ongoing global pandemic disease. There was the first outbreak in Thailand. The study aimed to study CXR findings of Mpox patients and describe the correlation between cycle threshold (Ct) from Real-time Polymerase Chain Reaction (Real-time PCR) for Mpox relative to pneumonia and death. This retrospective study evaluated Mpox patients treated at the Bamrasnaradura Infectious Diseases Institute during August 1, 2022 to September 30, 2023. There were 40 Mpox patients included in this study. Of these patients, 95.0% were Thai, 90.0% were male, and 55.0% were HIV positive. The average age of patients was 31.6 years. Among these patients, 15.4% were having pneumonia. The mortality rate was 5.0%. The most common CXR findings of Mpox-related pneumonia were reticular opacity (100%), bilateral lungs involvement (100%), both central and peripheral distribution (100%). Mean Ct from Real-time PCR for Mpox with pneumonia group was 19.21+1.97 and non-pneumonia group was 20.65+0.80 (p-value=0.562). Mean Ct from Real-time PCR for Mpox among fatal group was 16.32+0.18 and non-fatal group was 20.73+4.65 (p-value=0.193). Respiratory symptoms were not observed in all Mpox patients, so performing CXR was solely at the discretion of the treating physician. Lower value of Ct from Real-time PCR for Mpox that suggests higher pathogen load was not significantly correlated with pneumonia and death.

Downloads

Download data is not yet available.

References

World Health Organization. Multi-country outbreak of mpox [Internet]. 2023 [cited 2023 Nov 29]. Available from: https://www.who.int/publications/m/item/multi-country-outbreak-of-mpox--external-situation-report-30---25-november-2023.

Jezek Z, Szczeniowski M, Paluku KM, Mutombo M. Human monkeypox: clinical features of 282 patients. J Infect Dis 1987;156(2):293-8.

Ogoina D, Iroezindu M, James HI, Oladokun R, Yinka-Ogunleye A, Wakama P, et al. Clinical Course and Outcome of Human Monkeypox in Nigeria. Clin Infect Dis 2020;71(8):e210-4.

Mitja O, Ogoina D, Titanji BK, Galvan C, Muyembe J, Marks M, et al. Monkeypox. Lancet 2023;401:60-74.

Thornhill JP, Barkati S, Walmsley S, Rockstroh J, Antinori A, Harrison LB, et al. Monkeypox Virus Infection in Human across 16 Countries-April-June 2022. NEJM 2022;387:679-91. doi:10.1056/NEJMoa2207323.

Markewitz NF, Deluca J, Kalejaiye A, Shidid S, Jain T, Parikh P, et al. Mpox- Associated Pneumonia: A case report. Annals of Internal Medicine 2023;2(3):1-3. doi: 10.7326aimcc.2022.0945.

Vichaidit M, Trisukosol P, Kwangsuksatid A, Voravutinon N, Visutikul P, Katipattanapong P, et al. Mpox. Journal of Diagnostic Medical Sonography 2023;47(3):6-8. (in Thai)

Sirikup P. Monkeypox. Pediatric Infectious Disease Society of Thailand 2022;28(3):10-3. (in Thai)

Gessain A, Nakoune E, Yazdanpanah Y. Monkeypox. The New England Journal of Medicine 2022;387:1783-93.

Dou Y, Yuan H, Tian H. Monkeypox virus: past and present. World Journal of Pediatrics 2023;19:224-30.

Sanroman Guerrero MA, Sanchez EH, Ruanes BN, Fernandez-Gonzalez P, Ugalde SA, Leal AG, et al. Case report: From monkeypox pharyngitis to myopericarditis and atypical skin lesions. Front Cardiovasc Med 2022;9:1046498.

Pinho AI, Braga M, Vasconcelos M, Oliveira C, Santos LD, Guimaraes AR, et al. Acute myocarditis: A New Manifestation of Monkeypox infection? Journal of the American College of Cardiology 2022;4(21):1424-8.

Huhn GD, Bauer AM, Yorita K, Graham MB, Sejvar J, Likos A, et al. Clinical Characteristics of Human Monkeypox, and Risk Factors for Severe Disease. Clinical Infectious Disease 2005;41(12):1742-51.

Keikha M, Zandhaghighi M, Zahedani SS. Death-associated with human monkeypox outbreak 2022: the current perspectives-correspondence. International Journal of Surgery 2023;109:1806-7.

Yinka-Ogunleye A, Dalhat M, Akinpelu A, Aruna O, Garba F, Ahmad A, et al. Mpox (monkeypox) risk and mortality associated with HIV infection: a national case-control study in Nigeria. BMJ 2023;8. doi:10.1136/bmjgh-2023-013126.

Lum FM, Torres-Ruesta A, Tay MZ, Lin RT, Lye DC, Renia L, et al. Monkeypox: disease epidemiology, host immunity and clinical intervention. Nat Rev Immunol 2022;22:597-613.

Brown JN, Estep RD, Lopez-Ferrer D, Brewer HM, Clauss TR, Manes NP, et al. Characterization of Macaque Pulmonary Fluid Proteome during Monkeypox Infection: Dynamics of Host Response. Molecular & Cellular Proteomics, 2010; DOI: 10.1074/mcp.M110.001875.

Vichakjinda N. Pitfall in SARS-CoV-2 test with Real-time RT- PCR.1st ed. Bangkok: Kaenchand; 2020. (in Thai)

Downloads

Published

2024-09-18

How to Cite

1.
Vongthawatchai P, Kongpanya P, Nateniyom N. Chest X-ray findings in Mpox patients and the correlation between cycle threshold of Real-time PCR for Mpox relative to pneumonia and death in Bamrasnaradura Infectious Disease Institute. Dis Control J [Internet]. 2024 Sep. 18 [cited 2024 Sep. 27];50(3):409-21. Available from: https://he01.tci-thaijo.org/index.php/DCJ/article/view/268817

Issue

Vol. 50 No. 3 (2024): July-September

Section

Original Article

License

Copyright (c) 2024 Disease Control Journal

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Articles published in the Disease Control Journal are considered as academic work, research or analysis of the personal opinion of the authors, not the opinion of the Thailand Department of Disease Control or editorial team. The authors must be responsible for their articles.