Clinical Mimickers of Mpox: A Case Series from a Tropical Referral Center

Abstract

Mpox is a zoonotic disease caused by the monkeypox virus, a double-stranded DNA virus belonging to the genus Orthopoxvirus. The World Health Organization (WHO) declared mpox a Public Health Emergency of International Concern (PHEIC) in July 2022 amid the global clade IIb outbreak and again in August 2024 following an increase in cases in the Democratic Republic of the Congo associated with clades Ia and Ib. Despite increased awareness, diagnosing mpox remains challenging because its clinical manifestations often overlap with those of other infectious and non-infectious conditions. This diagnostic challenge occurs across geographic settings but may be further complicated in tropical regions by the circulation of locally prevalent infections, including arboviral diseases such as dengue and chikungunya. Here, we describe a series of nine patients initially evaluated for suspected mpox, in whom alternative diagnoses were subsequently established.