{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T16:54:56Z","timestamp":1787849696904,"version":"build-2784847793"},"reference-count":21,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2023,10,6]],"date-time":"2023-10-06T00:00:00Z","timestamp":1696550400000},"content-version":"vor","delay-in-days":5,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Medical Virology"],"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>During the current global outbreak of mpox (formerly monkeypox), atypical features were frequently described outside endemic areas, raising concerns around differential diagnosis. In this study, we included 372 adult patients who had clinical signs consistent with mpox and who were screened using non\u2010variola orthopoxvirus specific quantitative polymerase chain reaction (PCR) between 15 May and 15 November 2022 at the University Hospital Institute M\u00e9diterran\u00e9e Infection, Marseille, France. At least one clinical sample was positive for 143 (38.4%) of these patients and 229 (61.6%) were negative. Clinically, patients who had mpox presented more frequently with systemic signs (69.9% vs. 31.0%, <jats:italic>p<\/jats:italic>\u2009&lt;\u200910<jats:sup>\u22126<\/jats:sup>) including fever (51.0% vs. 30.1%, <jats:italic>p<\/jats:italic>\u2009&lt;\u200910<jats:sup>\u22123<\/jats:sup>), myalgia (33.5% vs. 17.9%, <jats:italic>p<\/jats:italic>\u2009=\u20090.002), and lymphadenopathy (38.5% vs. 13.1%, <jats:italic>p<\/jats:italic>\u2009&lt;\u200910<jats:sup>\u22126<\/jats:sup>). Among the patients who were negative for the non\u2010variola orthopoxvirus, an alternative diagnosis was identified in 58 of them (25.3%), including chickenpox (<jats:italic>n<\/jats:italic>\u2009=\u200930, 13.1%), syphilis (<jats:italic>n<\/jats:italic>\u2009=\u20099, 4%), bacterial skin infection (<jats:italic>n<\/jats:italic>\u2009=\u20098, 3.5%), gonococcus (<jats:italic>n<\/jats:italic>\u2009=\u20095, 2.2%), HSV infection (<jats:italic>n<\/jats:italic>\u2009=\u20095, 2.2%), and histoplasmosis (<jats:italic>n<\/jats:italic>\u2009=\u20091, 0.4%). Overall, in the current outbreak, we show that mpox has a poorly specific clinical presentation. This reinforces the importance of microbiological confirmation. In symptomatic patients who are negative for the monkeypox virus by PCR, a broad differential diagnosis should be maintained.<\/jats:p>","DOI":"10.1002\/jmv.29147","type":"journal-article","created":{"date-parts":[[2023,10,6]],"date-time":"2023-10-06T20:17:01Z","timestamp":1696623421000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["How to distinguish mpox from its mimickers: An observational retrospective cohort study"],"prefix":"10.1002","volume":"95","author":[{"given":"Coline","family":"Mortier","sequence":"first","affiliation":[{"name":"IHU Me\u0301diterrane\u0301e Infection Marseille France"},{"name":"Assistance Publique\u2010Ho\u0302pitaux de Marseille Marseille France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Herve\u0301","family":"Tissot\u2010Dupont","sequence":"additional","affiliation":[{"name":"IHU Me\u0301diterrane\u0301e Infection Marseille France"},{"name":"Assistance 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