A man with monkeypox was misdiagnosed and then nearly lost his sight

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A man with monkeypox was misdiagnosed and then nearly lost his sight

  • A man who tested negative for monkeypox had a facial rash so bad doctors feared he might go blind.
  • Kevin Kwong, 33, saw several health care providers before being treated for monkeypox.
  • The doctor treating him said he was “shocked” by how quickly Kwong responded to the drug TPOXX.

A man who tested negative twice for monkeypox had a facial rash so bad a doctor feared he might be going blind, according to local news reports.

Kevin Kwong, 33, was finally diagnosed at the University of California, San Francisco (UCSF) Medical Center in the first week of July, a few weeks after his symptoms first appeared.

When he met infectious disease specialist Peter Chin-Hong, who diagnosed him, Kwong was “miserable,” with hundreds of wounds all over his body, he told local news station KPCC.

At that point, he had attended six online appointments, called a nurse hotline, visited an emergency treatment center, and been to the emergency room twice, according to the San Francisco Chronicle. He had tried steroids for eczema and antivirals for herpes and was misdiagnosed with scabies. Monkeypox can cause a progressive skin rash that can be mistaken for other conditions.

“Depending on where I was with my symptoms and who I spoke to, I got different answers,” Kwong said. “Every time I spoke to someone, I got worse rapidly,” he said, the Chronicle reported.

“Kevin’s case was probably one of the most severe patient cases I’ve seen,” Chin-Hong, also a professor of medicine at UCSF, told KRON 4.

Itchy hand waking him up from sleep

Kwong’s symptoms began two days after he returned to California from New York in late June – with a painful, itchy hand that woke him from sleep, according to the KPCC.

He initially thought it was bad eczema and treated it with his usual steroid cream. But it got worse and spread to his elbows, and more red spots, leaking fluid, appeared on his face.

“Your body is being taken over by this thing you don’t understand. And you have nowhere to go, so it’s both painful and scary,” Kwong told the Chronicle.

8,934 cases of monkeypox have been confirmed in the US since an unusual outbreak began in May in countries where the disease was not normally reported. New York and California have the most cases, mostly among men who have sex with men, but anyone can get it regardless of sexuality. Experts believe monkeypox spreads through direct or intimate contact with an infected person or contaminated objects.

Kwong told KPCC that he believes he contracted it during a sexual encounter during the New York Pride.

Monkeypox is underdiagnosed

Monkeypox lesions of various types


UKHSA



dr Graham Walker, an emergency room doctor in San Francisco, told Insider that he’s seen patients like Kwong whose monkeypox was “missed.”

This is partly because monkeypox doesn’t behave like the “textbook” monkeypox presentations of the past, but neither may clinicians have treated it.

“I didn’t realize how little information was given to the vendors either, and how unprepared they were,” Kwong said.

even dr Timothy Brewer, a professor of medicine and epidemiology at UCLA who has worked at times in countries where monkeypox has historically been endemic, told the SF Chronicle that he has not treated a case. “Prior to this current outbreak, monkeypox was a very uncommon disease,” he said.

Kwong’s false-negative tests made the diagnosis difficult.

“As a clinician, it’s very difficult to really get a good sample with this type of lesion because the patient is often in pain,” Chin-Hong said. The CDC recommends doctors swab lesions twice and collect samples from multiple body parts or from lesions that look different.

Rapid recovery after treatment with TPOXX

Chin-Hong treated Kwong with tecovirimate, or “TPOXX” — a smallpox tablet that can be used for monkeypox with CDC permission.

Kwong said his facial rash improved from day one, and after two weeks, apart from scars, he had recovered.

“I was shocked at how quickly Kevin improved,” Chin-Hong told KPCC.

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