Monkeypox after occupational needlestick Injury

A case of monkeypox is reported involving a physician after an occupational needlestick injury from a pustule. This case highlights risk for occupational transmission and manifestations of the disease after percutaneous transmission: a short incubation period, followed by a solitary lesion at the injured site and later by systemic symptoms.

A healthy 29-year-old male physician from the Infectious Diseases Department of a tertiary hospital in Portugal had a needlestick injury in the left index finger with a needle used to collect a fluid sample from a man who had a pustular rash, later confirmed to be monkeypox. The physician punctured a pustule with the needle because he was unable to obtain material by swabbing it.

Four days later, a vesicle appeared on the pricked finger (Figure 1, panel A), and monkeypox virus (MPXV) was identified in its fluid by PCR. On the sixth day of illness, fever (temperature 38.4°C), chills, and malaise developed and lasted for ≈48 hours. The finger lesion became pustular and painful and showed surrounding erythema and swelling (Figure 1, panel B). A tender, indurated, erythematous and well-delimited linear streak from the left finger to the armpit appeared on the seventh day, without regional adenopathy. MPXV PCR was repeated in samples from the oropharynx and blood; again, results were negative.


It is surely clear to everyone that sharps injury risks not only the transmission og Hep B, Hep C and HIV infection.

Take great care at all times, at the bedside and far beyond.

Monkeypox After Occupational Needlestick Injury From Pustule (

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