We describe a case of mpox characterized by a circularly distributed facial rash but no identified risk factors. Fomite transmission of monkeypox virus from contaminated linen at a massage spa was suspected. Clinicians should consider mpox in patients with consistent clinical syndromes, even in the absence of epidemiologic risk factors.
During the 2022 global outbreak, ≈95% of mpox cases, caused by monkeypox virus infection, were attributed to close physical contact, and >98% were reported among men.[1,2] We describe a case of a young woman who had no sexual or close physical contact with anyone suspected of having mpox during the 2 months before she had a confirmed monkeypox virus infection.
A woman in the United States in her late 20s, who had hypothyroidism after curative thyroidectomy for medullary thyroid cancer 7 years before, sought care in July 2022 at a hospital emergency department 8 days after a facial rash developed. The rash was initially pruritic, and erythematous macules were located on the bilateral infraorbital and malar areas, lower cutaneous lip, and chin, which progressed to vesicles followed by pustules. She was prescribed doxycycline and valacyclovir. She experienced subjective fevers, myalgias, bilateral cervical lymphadenopathy, and scattered papules that developed bilaterally on her legs and arms, prompting her to return to the emergency department (Figure).
