{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,30]],"date-time":"2025-12-30T15:38:55Z","timestamp":1767109135547,"version":"build-2065373602"},"reference-count":29,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2022,12,23]],"date-time":"2022-12-23T00:00:00Z","timestamp":1671753600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Vaccines"],"abstract":"<jats:p>Mpox Virus (MPXV) is a zoonotic infectious disease first identified in 1970 in rural villages in rainforest areas of central and western Africa when smallpox was in the final stages of eradication. Since May 2022, cases and sustained transmission chains of monkeypox have been reported for the first time in countries where the disease is not endemic and without cases having direct or immediate epidemiological links to areas of West or Central Africa (travel, importation of mammals). On 23 July 2022, WHO declared monkeypox a \u201cPublic Emergency of International Concern\u201d (PHEIC). In this paper, we report two cases of a Polymerase Chain Reaction (PCR)-confirmed MPXV infection. A 39-year-old Italian male came to our attention for a suspected herpetic infection, fever, headache, and malaise, which were followed by the development of an erythematous plaque covered by vesicles on the chin, an oval ulcer with a white peripheral border on the lower lip, and a central erosive area and three pustules on the arms and trunk. During the physical examination, cervical lymphadenopathy was also detected. PCR investigation of the patient and his partner confirmed the presence of MPXV infection. Our report describes a possible clinical feature of Mpox disease and illustrates the challenge of a disease that seems to present itself in different ways.<\/jats:p>","DOI":"10.3390\/vaccines11010036","type":"journal-article","created":{"date-parts":[[2022,12,27]],"date-time":"2022-12-27T04:42:47Z","timestamp":1672116167000},"page":"36","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Peri-oral Monkeypox Virus Infection: A Clinical Report with Confirmatory Polymerase Chain Reaction Findings"],"prefix":"10.3390","volume":"11","author":[{"given":"Francesca","family":"Ambrogio","sequence":"first","affiliation":[{"name":"Section of Dermatology and Venereology, Department of Biomedical Sciences and Human Oncology (DIMO), University of Bari \u201cAldo Moro\u201d, 70124 Bari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5074-4951","authenticated-orcid":false,"given":"Carmelo","family":"Laface","sequence":"additional","affiliation":[{"name":"Interventional and Medical Oncology Unit, IRCCS Istituto Tumori \u201cGiovanni Paolo II\u201d, Viale Orazio Flacco 65, 70124 Bari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna Paola","family":"De Caro","sequence":"additional","affiliation":[{"name":"Section of Dermatology and Venereology, Department of Biomedical Sciences and Human Oncology (DIMO), University of Bari \u201cAldo Moro\u201d, 70124 Bari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2057-9745","authenticated-orcid":false,"given":"Daniela","family":"Loconsole","sequence":"additional","affiliation":[{"name":"Department of Biomedical Science and Human Oncology (DIMO), University of Bari \u201cAldo Moro\u201d, 70124 Bari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3018-5408","authenticated-orcid":false,"given":"Francesca","family":"Centrone","sequence":"additional","affiliation":[{"name":"Department of Biomedical Science and Human Oncology (DIMO), University of Bari \u201cAldo Moro\u201d, 70124 Bari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0860-3044","authenticated-orcid":false,"given":"Teresa","family":"Lettini","sequence":"additional","affiliation":[{"name":"Section of Pathology, Department of Emergency and Organ Transplantation (DETO), University of Bari \u201cAldo Moro\u201d, 70124 Bari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0325-4316","authenticated-orcid":false,"given":"Gerardo","family":"Cazzato","sequence":"additional","affiliation":[{"name":"Section of Pathology, Department of Emergency and Organ Transplantation (DETO), University of Bari \u201cAldo Moro\u201d, 70124 Bari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1319-4946","authenticated-orcid":false,"given":"Domenico","family":"Bonamonte","sequence":"additional","affiliation":[{"name":"Section of Dermatology and Venereology, Department of Biomedical Sciences and Human Oncology (DIMO), University of Bari \u201cAldo Moro\u201d, 70124 Bari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caterina","family":"Foti","sequence":"additional","affiliation":[{"name":"Section of Dermatology and Venereology, Department of Biomedical Sciences and Human Oncology (DIMO), University of Bari \u201cAldo Moro\u201d, 70124 Bari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1043-1256","authenticated-orcid":false,"given":"Maria","family":"Chironna","sequence":"additional","affiliation":[{"name":"Department of Biomedical Science and Human Oncology (DIMO), University of Bari \u201cAldo Moro\u201d, 70124 Bari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paolo","family":"Romita","sequence":"additional","affiliation":[{"name":"Section of Dermatology and Venereology, Department of Biomedical Sciences and Human Oncology (DIMO), University of Bari \u201cAldo Moro\u201d, 70124 Bari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,12,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"102855","DOI":"10.1016\/j.jaut.2022.102855","article-title":"The 2022 outbreak and the pathobiology of the monkeypox virus","volume":"131","author":"Kumar","year":"2022","journal-title":"J. Autoimmun."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1016\/S0014-5793(01)03144-1","article-title":"Human monkeypox and smallpox viruses: Genomic comparison","volume":"509","author":"Shchelkunov","year":"2001","journal-title":"FEBS Lett."},{"key":"ref_3","unstructured":"World Health Organization (2022, June 07). Multi-Country Monkeypox Outbreak in Non-Endemic Countries. Available online: https:\/\/www.who.int\/emergencies\/disease-outbreak-news\/item\/2022-DON390."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"106949","DOI":"10.1016\/j.ijsu.2022.106949","article-title":"Recent first report of human-to-dog transmission of Monkeypox virus emphasizes an urgent need of enhancing surveillance and strengthen further explorative research to reveal its real magnitude of reverse zoonosis from other animals including pets as like that happened with SARS-CoV-2\/COVID-19 pandemic\u2014Correspondence","volume":"106","author":"Sah","year":"2022","journal-title":"Int. J. Surg."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Alshahrani, N.Z., Alzahrani, F., Alarifi, A.M., Algethami, M.R., Alhumam, M.N., Ayied, H.A.M., Awan, A.Z., Almutairi, A.F., Bamakhrama, S.A., and Almushari, B.S. (2022). Assessment of Knowledge of Monkeypox Viral Infection among the General Population in Saudi Arabia. Pathogens, 11.","DOI":"10.3390\/pathogens11080904"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1027","DOI":"10.1016\/j.idc.2019.03.001","article-title":"Human Monkeypox: Epidemiologic and Clinical Characteristics, Diagnosis, and Prevention","volume":"33","author":"Petersen","year":"2019","journal-title":"Infect. Dis. Clin. N. Am."},{"key":"ref_7","first-page":"e26531","article-title":"Monkeypox: A Comprehensive Review of Transmission, Pathogenesis, and Manifestation","volume":"14","author":"Kaler","year":"2022","journal-title":"Cureus"},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Alakunle, E., Moens, U., Nchinda, G., and Okeke, M.I. (2020). Monkeypox Virus in Nigeria: Infection Biology, Epidemiology, and Evolution. Viruses, 12.","DOI":"10.3390\/v12111257"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1016\/j.jviromet.2010.07.012","article-title":"Real-time PCR assays for the specific detection of monkeypox virus West African and Congo Basin strain DNA","volume":"169","author":"Li","year":"2010","journal-title":"J. Virol. Methods"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1186\/s12941-022-00518-2","article-title":"Monkeypox outbreaks during COVID-19 pandemic: Are we looking at an independent phenomenon or an overlapping pandemic?","volume":"21","author":"Farahat","year":"2022","journal-title":"Ann. Clin. Microbiol. Antimicrob."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Bunge, E.M., Hoet, B., Chen, L., Lienert, F., Weidenthaler, H., Baer, L.R., and Steffen, R. (2022). The changing epidemiology of human monkeypox-A potential threat? A systematic review. PLoS Negl. Trop. Dis., 16.","DOI":"10.1371\/journal.pntd.0010141"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"102386","DOI":"10.1016\/j.tmaid.2022.102386","article-title":"New challenges in human monkeypox outside Africa: A review and case report from Italy","volume":"49","author":"Mileto","year":"2022","journal-title":"Travel. Med. Infect. Dis."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"102394","DOI":"10.1016\/j.tmaid.2022.102394","article-title":"Monkeypox virus: A novel sexually transmitted disease? A case report from France","volume":"49","author":"Farfour","year":"2022","journal-title":"Travel. Med. Infect. Dis."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"100078","DOI":"10.1016\/j.jve.2022.100078","article-title":"A viewpoint: The 2022 monkeypox outbreak","volume":"8","author":"Bhagani","year":"2022","journal-title":"J. Virus Erad."},{"key":"ref_15","unstructured":"Moreno, D.M., and Escribano, P.C. (2022). Infecci\u00f3n por virus de la viruela del mono. Caso cl\u00ednico. Actas Dermosifiliogr."},{"key":"ref_16","first-page":"647","article-title":"Transmission of monkeypox virus through sexual contact\u2014A novel route of infection","volume":"81","author":"Heskin","year":"2022","journal-title":"J. Infect."},{"key":"ref_17","first-page":"e1016","article-title":"Monkeypox: A new (sexually transmissible) epidemic?","volume":"36","author":"Frade","year":"2022","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"773","DOI":"10.1086\/505880","article-title":"Clinical manifestations of human monkeypox influenced by route of \u2028infection","volume":"194","author":"Reynolds","year":"2006","journal-title":"J. Infect. Dis."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1742","DOI":"10.1086\/498115","article-title":"Clinical \u2028characteristics of human monkeypox, and risk factors for severe disease","volume":"41","author":"Huhn","year":"2005","journal-title":"Clin. Infect. Dis."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"955","DOI":"10.1007\/s12098-022-04348-0","article-title":"Monkeypox: A Review","volume":"89","author":"Singhal","year":"2022","journal-title":"Indian J. Pediatr."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"e072410","DOI":"10.1136\/bmj-2022-072410","article-title":"Clinical features and novel presentations of human monkeypox in a central London centre during the 2022 outbreak: Descriptive case series","volume":"378","author":"Patel","year":"2022","journal-title":"BMJ"},{"key":"ref_22","first-page":"e658","article-title":"Monkeypox virus case with maculopapular exanthem and proctitis during the Spanish outbreak in 2022","volume":"36","author":"Vivancos","year":"2022","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1153","DOI":"10.1016\/S1473-3099(22)00228-6","article-title":"NHS England High Consequence Infectious Diseases (Airborne) Network. Clinical features and management of human monkeypox: A retrospective observational study in the UK","volume":"22","author":"Adler","year":"2022","journal-title":"Lancet Infect. Dis."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"100055","DOI":"10.1016\/j.hsr.2022.100055","article-title":"Clinical manifestations of human monkeypox infection and implications for outbreak strategy","volume":"5","author":"Johri","year":"2022","journal-title":"Health Sci. Rev."},{"key":"ref_25","unstructured":"(2022, August 01). About Monkeypox, Available online: https:\/\/www.cdc.gov\/poxvirus\/monkeypox\/about.html."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"593","DOI":"10.1016\/j.jormas.2022.06.020","article-title":"Mouth sores and monkeypox: A consideration","volume":"123","author":"Sookaromdee","year":"2022","journal-title":"J. Stomatol. Oral Maxillofac. Surg."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"483","DOI":"10.17219\/dmp\/152071","article-title":"Oral manifestations of monkeypox: Brief review","volume":"59","author":"Iamaroon","year":"2022","journal-title":"Dent. Med. Probl."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"679","DOI":"10.1056\/NEJMoa2207323","article-title":"Monkeypox virus infection in humans across 16 countries\u2014April\u2013June 2022","volume":"387","author":"Thornhill","year":"2022","journal-title":"N. Engl. J. Med."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Pandya, V.S., Mehta, V., Miraj, M., Alasiry, S.M., Alanazy, W., Uthup, T.T., Shaik, R.A., D\u2019Amico, C., Mancini, M., and Gorassini, F. (2022). Monkeypox: An Unfamiliar Virus-Clinical and Epidemiological Characteristics, Diagnosis, and Treatment with Special Emphasis on Oral Health. Diagnostics, 12.","DOI":"10.3390\/diagnostics12112749"}],"container-title":["Vaccines"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-393X\/11\/1\/36\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:49:37Z","timestamp":1760147377000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-393X\/11\/1\/36"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12,23]]},"references-count":29,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2023,1]]}},"alternative-id":["vaccines11010036"],"URL":"https:\/\/doi.org\/10.3390\/vaccines11010036","relation":{},"ISSN":["2076-393X"],"issn-type":[{"type":"electronic","value":"2076-393X"}],"subject":[],"published":{"date-parts":[[2022,12,23]]}}}