Clinical features, treatment, and outcomes of mpox in solid organ transplant recipients: A multicenter case series and literature review Article

Full Text via DOI: 10.1016/j.ajt.2023.07.016 Web of Science: 001165304600001

Cited authors

  • Higgins E, Ranganath N, Mehkri O, Majeed A, Walker J, Spivack S, Bhaimia E, Benamu E, Hand J, Keswani S, Dunn D, Beam E, Razonable RR

Abstract

  • In 2022, the largest global outbreak of mpox to date emerged. In the immunocompetent host, mpox generally presents as a self-limiting illness. However, immunosuppression, such as that seen with advanced HIV, has been associated with significant morbidity and mor-tality related to mpox infection. To evaluate the impact of immunosuppression related to solid organ transplantation on clinical features and outcomes of mpox we established a multicenter case registry. Eleven cases from 7 participating centers in the USA were submitted. All cases occurred in males. The majority were kidney transplant recipients (91%, n = 10). Median duration of symptoms at presentation was 6 days (range, 3-14 days). Rates of hospitalization were high (73%, n = 8) with a median length of stay of 4.5 days (range, 1-10 days). Mpox in solid organ transplant recipients was associated with a high burden of skin lesions and systemic symptoms. Fever, fatigue, pharyngitis, and proctitis were commonly reported. Other clinical features included headache, myalgia, epididymo-orchitis, urinary retention, hematemesis, pneumonitis, and circulatory shock. All patients received treatment with tecovirimat. There was 1 mpox-related death in the cohort. Infection was reported to have resolved at 30-day follow-up in all other cases.

Publication date

  • 2023

Published in

International Standard Serial Number (ISSN)

  • 1600-6135

Number of pages

  • 8

Start page

  • 1972

End page

  • 1979

Volume

  • 23

Issue

  • 12