Case report: Pox-like lesions and haemorrhagic fever in two concurrent cases in the Central African Republic: case investigation and management in difficult circumstances

Abstract

Cases of monkeypox in humans are frequently reported from the Democratic Republic of Congo. The few  reports from the Central African Republic have been limited to cases in the far South closely bordering the    Congos. Team members of an international medical organisation have suspected clinically two human cases of MPX, associated with clinical signs of coagulopathy and haemorrhage in the North of the country. Key findings  were history of a squirrel, fever and vesicular dermal eruptions. Subsequently patients developed profuse  epistaxis and hematemesis, associated with clinical signs of shock. Both patients were isolated and treated  symptomatically. Samples were sent to a regional reference laboratory, who initially issued a confirmation of  the suspected diagnosis of MPX in both cases. The result was later revised, and additional analyses of samples could not confirm the diagnosis.

Key words: Pox-like lesions, monkeypox, Central African Republic, haemorrhage, fever