Monkeypox Presenting as Ototoxicity and Developing into Tinnitus as a Sequela: A Case Report

Abstract

Background

A 35 year old male presented to the emergency department with ear pain and a rash of five days duration. The patient stated there was also discharge from his left ear. Two days prior the patient developed a lesion on his chin, which progressed to several circular papules with central eschar over his cheeks, behind his left ear, on his neck, and over his upper extremities. The patient’s initial ear pain developed into tinnitus as a sequela. The patient has a prior history of AIDS which is being managed with Symtuza and Bactrim.

Monkeypox is a zoonotic viral disease caused by the Monkeypox virus, a member of the Orthopoxvirus genus. Transmission occurs through direct contact with infected individuals, or contact with respiratory droplets, bodily fluids, or contaminated objects. Initially monkeypox presents with flu-like symptoms, followed by the development of a distinctive rash. 

Results

The case demonstrates a unique example of otalgia that developed into tinnitus in an AIDS patient infected with Monkeypox. Previous studies have reported clinical presentation of Monkeypox as rashes in penile, perianal, and pharyngeal areas, tonsillitis, epiglottis, bronchopneumonia, myocarditis, and encephalitis. However, there are currently no cases describing otalgia and tinnitus as a presentation and adverse complication of Monkeypox in the literature. An in-depth review of the current presentations and adverse complications of Monkeypox provides a foundation for improving diagnostic accuracy, patient management, and public health response strategies in affected areas. The examination of diverse clinical presentations and potential complications associated with Monkeypox, aids healthcare professionals in differentiating monkeypox from similar conditions, such as chicken pox or herpes zoster, leading to a more accurate diagnosis and reduced spread of the disease.

Conclusion

The identification of new clinical presentations for Monkeypox is important for public health for early diagnosis and reducing onward transmission. Consolidation of the current knowledge on unique presentations and adverse complications of Monkeypox serves as a valuable resource for future research endeavors.