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CASE REPORT article

Front. Med.
Sec. Infectious Diseases: Pathogenesis and Therapy
Volume 11 - 2024 | doi: 10.3389/fmed.2024.1387407

A Comprehensive Report on the First Confirmed Mpox Case in the Philippines during the 2022 Mpox Global Outbreak: From Clinical Presentation to Shotgun Metagenomic Sequencing Analysis

Provisionally accepted
Edward Matthew Ylaya Edward Matthew Ylaya Phoebe Grace B. Grande Phoebe Grace B. Grande *Lei Lanna Dancel Lei Lanna Dancel Amalea Dulcene Nicolasora Amalea Dulcene Nicolasora Francisco Gerardo Polotan Francisco Gerardo Polotan Roslind Anne Pantoni Roslind Anne Pantoni Ezekiel Melo Ezekiel Melo Stephen Paul Ortia Stephen Paul Ortia Joanna Ina Manalo Joanna Ina Manalo Miguel Francisco Abulencia Miguel Francisco Abulencia Maria Yna Joyce Chu Maria Yna Joyce Chu Timothy John Dizon Timothy John Dizon Ma. Carmela B. Sy Ma. Carmela B. Sy Gisella Adasa Gisella Adasa Aileen G. Gascon Aileen G. Gascon Arthur Dessi Roman Arthur Dessi Roman
  • Research Institute for Tropical Medicine (RITM), Alabang Muntinlupa, Philippines

The final, formatted version of the article will be published soon.

    We report a case of a 31-year-old Filipino male with travel history to several European countries in July 2022. He developed five non-tender, well-defined, umbilicated pustules with erythematous borders on the upper lip, left gluteal area, bilateral knees, and left ankle. Skin punch biopsy findings were suggestive of a viral infection. Mpox infection from Clade II (previously known as the West African clade) was confirmed by detecting and amplifying the G2R_G, G2R_WA and C3L gene targets using qPCR. Shotgun metagenomic sequencing subsequently identified a Mpox genome sequence belonging to B.1.3 lineage of Clade IIb, associated with the current multi-country outbreak. Serologic varicella IgM test was positive but varicella PCR of the skin lesion and metagenomic sequencing did not indicate the presence of the varicella virus. The patient was discharged and continued isolation at home until all scabs had completely fallen off. The presence of pustules among patients with risk factors such as possible close physical contact with infected individuals in areas with reported cases of Mpox should raise suspicion for such an infection. Establishment and optimization of qPCR protocol were necessary to confirm Mpox infection. Metagenomic sequencing successfully characterized the etiologic agent of the first laboratory-confirmed Mpox case in the Philippines belonging to Clade IIb which is mainly responsible for the 2022 Mpox global outbreak.

    Keywords: mpox, Dermatopathology, Shotgun metagenomic sequencing, Polymerase Chain Reaction, Philippines

    Received: 20 Feb 2024; Accepted: 02 Oct 2024.

    Copyright: © 2024 Ylaya, Grande, Dancel, Nicolasora, Polotan, Pantoni, Melo, Ortia, Manalo, Abulencia, Chu, Dizon, Sy, Adasa, Gascon and Roman. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Phoebe Grace B. Grande, Research Institute for Tropical Medicine (RITM), Alabang Muntinlupa, Philippines

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