2022年猴痘临床表现，猴痘临床试验研究机构

临床表现

clinical manifestation

潜伏期5-21天，多为6-13天。发病早期出现寒战、发热，体温多在38.5℃以上，可伴头痛、嗜睡、乏力、背部疼痛和肌痛等症状。多数患者出现颈部、腋窝、腹股沟等部位淋巴结肿大。发病后1-3天出现皮疹。皮疹首先出现在面部，逐渐蔓延至四肢及其他部位，皮疹多呈离心性分布，面部和四肢皮疹较躯干更为多见，手心和脚掌均可出现皮疹，皮疹数量从数个到数千个不等；也可累及口腔黏膜、消化道、生殖器、结膜和角膜等。皮疹经历从斑疹、丘疹、疱疹、脓疱疹到结痂几个阶段的变化，疱疹和脓疱疹多为球形，直径约0.5-1厘米，质地较硬，可伴明显痒感和疼痛。从发病至结痂脱落约2-4周。结痂脱落后可遗留红斑或色素沉着，甚至瘢痕，瘢痕持续时间可长达数年。部分患者可出现并发症，包括皮损部位继发细菌感染、支气管肺炎、脑炎、角膜感染、脓毒症等。

The incubation period is 5-21 days, mostly 6-13 days. Shivering and fever occur in the early stage of the disease, and the body temperature is mostly above 38.5 ℃, which can be accompanied by headache, lethargy, fatigue, back pain, myalgia and other symptoms. Most patients have swollen lymph nodes in the neck, armpit, groin and other parts. Rash occurs 1-3 days after onset. The rash first appeared on the face and gradually spread to the limbs and other parts. The rash was mostly distributed centrifugally. The rash on the face and limbs was more common than that on the trunk. The rash could appear on the palm and sole of the foot, and the number of rashes ranged from several to thousands; It can also involve oral mucosa, digestive tract, genitals, conjunctiva and cornea. The rash goes through several stages from macula, papule, herpes, purulent herpes to scab. Herpes and purulent herpes are mostly spherical, about 0.5-1 cm in diameter, hard in texture, and can be accompanied by obvious itching and pain. It takes about 2-4 weeks from the onset to scabbing and falling off. After scabs fall off, erythema or pigmentation can be left, and even scars, which can last for several years. Some patients may have complications, including bacterial infection secondary to skin lesions, bronchopneumonia, encephalitis, corneal infection, sepsis, etc.

猴痘为自限性疾病，大部分预后良好。严重病例常见于年幼儿童、免疫功能低下人群，预后与感染的病毒分支、病毒暴露程度、既往健康状况和并发症严重程度等有关。西非分支病死率约3%，刚果盆地分支病死率约10%。

Monkeypox is a self limiting disease, and most of them have a good prognosis. Severe cases are common in young children and people with low immune function. The prognosis is related to the infected virus branch, the degree of virus exposure, previous health status and the severity of complications. The mortality of West African branch is about 3%, and that of Congo Basin branch is about 10%.

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