Upper Airway Manifestations of Monkeypox: A Case Report and Literature Review.

Background: The monkeypox virus (MPXV) has spread globally, causing an infection similar to that of smallpox. In July 2022, MPXV was declared an international public health emergency by the World Health Organization. Although the prodromal and cutaneous symptoms are described, the literature is lacking with regard to the upper airway manifestations of the disease. Methods: This case report describes a 39-year-old gentleman with a history of human immunodeficiency virus who presented to the emergency department with fever, sore throat, and cough. A literature review was also performed to determine the clinical presentation and physical examination findings of patients presenting with MPXV. Results: The patient underwent flexible laryngoscopy on two separate occasions due to his symptoms of fever and sore throat. He was noted to have white plaque-like lesions throughout the upper aerodigestive tract that could not be excised with manipulation. Ultimately, he tested positive for MPXV and was treated with full recovery. Conclusions: To our knowledge, this is the first report describing upper airway manifestations of MPXV. Since patients with MPXV often present initially with pharyngitis, understanding the physical examination findings of MPXV in the upper airway is imperative for early diagnosis and public health awareness.