First case report of monkeypox in Brazil: clinical manifestations and differential diagnosis with sexually transmitted infections

ABSTRACT In 2022, an outbreak of monkeypox is being reported in non-endemic areas, with unusual clinical manifestations. The detailed clinical description of the first patient that received the diagnosis of monkeypox in Brazil is reported here, whose clinical manifestations can easily lead to misdiagnosis of sexually transmitted infections. A 41 years old male presented to an emergency room with a vesicular rash with eight days of evolution. He had traveled to Portugal and Spain and reported non-penetrative sexual involvement with three different male individuals. On the third day of symptoms, he sought medical care and received empirical treatment directed to sexually transmitted infections. As the symptoms did not improve, he sought medical attention at an infectious disease referral center presenting, on admission, an ulcerated penile lesion with central necrotic crusts, a disseminated pleomorphic skin rash and an oropharyngeal ulcer. The monkeypox diagnosis was suspected due to the characteristics of the lesions and the history of intimate contact with casual partners, and it was later confirmed by sequencing the almost complete monkeypox genome. The patient was hospitalized for pain control, which required opiate administration. He developed a secondary bacterial infection on the penile lesions, which were treated with oral antibiotics. He was discharged after 14 days, with lesions in process of re-epithelialization. Given the current outbreak, we must consider the possibility of monkeypox in patients with suggestive lesions, anywhere on the body (including the genitals), added to an epidemiological link or history of intimate contact with strangers or casual partners.

Percepção de mães sobre o uso de práticas integrativas e complementares em seus filhos / Mothers’ perception about the use of integrative and complementary practices in their children

Este estudo teve como objetivos descrever as práticas integrativas e complementares pelas mães em seus filhos, identificar motivos que as levam ao uso e discutir a percepção de mães sobre essas práticas. Pesquisa qualitativa, realizada em um Centro de Saúde de Teresina-PI, com 10 mães de crianças menores de 5 anos. Essas percebem massagem, xarope, orações de maneira positiva a insatisfação com a medicina tradicional, crenças e cultura os motivos que as levam a utilização. São necessárias orientações e assistência integral as mães, enfocando o uso racional dessas práticas na saúde da criança.

This study aimed to describe the complementary and integrative practices by mothers on their children, to identify reasons that lead to the use and discuss the perceptions of mothers about such practices. Qualitative research conducted in a Health Centre of Teresina-PI, with 10 mothers of children under 5 years. They perceive massage, syrup, prayers positively dissatisfaction with traditional medicine, cultural beliefs and the reasons that lead them to use. Guidelines are necessary and integral care mothers, focusing on the rational use of these practices on children’s health.

Este estudio tuvo como objetivo describir las prácticas complementarias y de integración de las madres sobre sus hijos, para identificar las razones que conducen a la utilización y analizar las percepción cualitativa realizada en un Centro de Salud de Teresina-PI, com 10 madres de niños menores de 5 anõs. Ellos perciben El masaje, el jarabe, las oraciones de una manera positiva la insatisfacción com la medicina tradicional, las creencias culturales y las razones que lês llevan a utilizar. Directrices son madres de cuidado necesarias e integral, centrado en el uso racional de estas prácticas em la salud de los niños.