Neonatal mpox in Nigeria: a case of transplacental or postnatal transmission

Abstract Background Little information exists in the literature regarding the burden and impact of mpox infection in the newborn population since the detection of the first case of human mpox over five decades ago. Case presentation We report a case of laboratory-confirmed mpox in a full-term male n...

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Main Authors: Chizaram Anselm Onyeaghala, Ezioma Anne Alinnor, Mary Irabor, Jennifer Ngufan Nongo, Idorenyin Diamond, Chioma Ada Nnah, Uju Stella Azubogu, Paul Ichendu Nsirimobu, Omosivie Maduka, Peace Opara, Rosemary Ogochukwu Ugwu, Datonye Dennis Alasia
Format: Article
Language:English
Published: BMC 2025-08-01
Series:BMC Infectious Diseases
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Online Access:https://doi.org/10.1186/s12879-025-11362-y
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author Chizaram Anselm Onyeaghala
Ezioma Anne Alinnor
Mary Irabor
Jennifer Ngufan Nongo
Idorenyin Diamond
Chioma Ada Nnah
Uju Stella Azubogu
Paul Ichendu Nsirimobu
Omosivie Maduka
Peace Opara
Rosemary Ogochukwu Ugwu
Datonye Dennis Alasia
author_facet Chizaram Anselm Onyeaghala
Ezioma Anne Alinnor
Mary Irabor
Jennifer Ngufan Nongo
Idorenyin Diamond
Chioma Ada Nnah
Uju Stella Azubogu
Paul Ichendu Nsirimobu
Omosivie Maduka
Peace Opara
Rosemary Ogochukwu Ugwu
Datonye Dennis Alasia
author_sort Chizaram Anselm Onyeaghala
collection DOAJ
description Abstract Background Little information exists in the literature regarding the burden and impact of mpox infection in the newborn population since the detection of the first case of human mpox over five decades ago. Case presentation We report a case of laboratory-confirmed mpox in a full-term male neonate with HIV-exposure who presented with a febrile vesiculo-pustular rash syndrome and a centrifugal pattern of distribution (marked on the scalp, face, neck and limbs and sparse on the thorax and abdomen) on day 16 of life at the University of Port Harcourt Teaching Hospital, Rivers State, Nigeria. He had his first skin eruption on the fourth day of life. There was a history of similar lesions in both parents, who are living with human immunodeficiency virus. Vesicular fluid polymerase chain reaction testing confirmed the presence of monkeypox virus (MPXV) DNA and was negative for varicella-zoster virus. Despite the diagnosis of mpox in the early neonatal period with the high likelihood of a transplacental route of transmission, the possibility of a postnatal transmission could not be entirely ruled out. He was optimized on supportive care including nutrition, skin care, fluid management, blood transfusion, and the use of targeted antibiotics. While on admission, he developed bacterial skin co-infection with methicillin-resistant Staphylococcus aureus, prolonged illness, and eventually recovered following a delayed time to resolution of skin lesion of 48 days. Conclusions Neonatal mpox infection is rare and could lead to prolonged morbidity and mortality. Clinicians should always maintain a high index of suspicion and consider mpox in the differential diagnosis of a neonatal vesiculo-pustular rash, particularly if there is a history of similar rash in the family, as early disease recognition and early treatment are associated with improved outcomes. Further studies are needed to better understand the transmission routes of MPXV in newborns.
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spelling doaj-art-e9575e0c967a4cc5b1a4c55e38a083f72025-08-20T03:04:10ZengBMCBMC Infectious Diseases1471-23342025-08-012511810.1186/s12879-025-11362-yNeonatal mpox in Nigeria: a case of transplacental or postnatal transmissionChizaram Anselm Onyeaghala0Ezioma Anne Alinnor1Mary Irabor2Jennifer Ngufan Nongo3Idorenyin Diamond4Chioma Ada Nnah5Uju Stella Azubogu6Paul Ichendu Nsirimobu7Omosivie Maduka8Peace Opara9Rosemary Ogochukwu Ugwu10Datonye Dennis Alasia11Department of Internal Medicine, University of Port Harcourt Teaching HospitalDepartment of Paediatrics, University of Port Harcourt Teaching HospitalDepartment of Paediatrics, University of Port Harcourt Teaching HospitalDepartment of Paediatrics, University of Port Harcourt Teaching HospitalDepartment of Paediatrics, University of Port Harcourt Teaching HospitalDepartment of Paediatrics, University of Port Harcourt Teaching HospitalDepartment of Paediatrics, University of Port Harcourt Teaching HospitalDepartment of Paediatrics, University of Port Harcourt Teaching HospitalDepartment of Community Medicine, University of Port Harcourt Teaching HospitalDepartment of Paediatrics, University of Port Harcourt Teaching HospitalDepartment of Paediatrics, University of Port Harcourt Teaching HospitalDepartment of Internal Medicine, University of Port Harcourt Teaching HospitalAbstract Background Little information exists in the literature regarding the burden and impact of mpox infection in the newborn population since the detection of the first case of human mpox over five decades ago. Case presentation We report a case of laboratory-confirmed mpox in a full-term male neonate with HIV-exposure who presented with a febrile vesiculo-pustular rash syndrome and a centrifugal pattern of distribution (marked on the scalp, face, neck and limbs and sparse on the thorax and abdomen) on day 16 of life at the University of Port Harcourt Teaching Hospital, Rivers State, Nigeria. He had his first skin eruption on the fourth day of life. There was a history of similar lesions in both parents, who are living with human immunodeficiency virus. Vesicular fluid polymerase chain reaction testing confirmed the presence of monkeypox virus (MPXV) DNA and was negative for varicella-zoster virus. Despite the diagnosis of mpox in the early neonatal period with the high likelihood of a transplacental route of transmission, the possibility of a postnatal transmission could not be entirely ruled out. He was optimized on supportive care including nutrition, skin care, fluid management, blood transfusion, and the use of targeted antibiotics. While on admission, he developed bacterial skin co-infection with methicillin-resistant Staphylococcus aureus, prolonged illness, and eventually recovered following a delayed time to resolution of skin lesion of 48 days. Conclusions Neonatal mpox infection is rare and could lead to prolonged morbidity and mortality. Clinicians should always maintain a high index of suspicion and consider mpox in the differential diagnosis of a neonatal vesiculo-pustular rash, particularly if there is a history of similar rash in the family, as early disease recognition and early treatment are associated with improved outcomes. Further studies are needed to better understand the transmission routes of MPXV in newborns.https://doi.org/10.1186/s12879-025-11362-yNeonatal MpoxNigeriaTransplacental transmissionPostnatal transmissionMonkeypox virusMethicillin-resistant Staphylococcus aureus
spellingShingle Chizaram Anselm Onyeaghala
Ezioma Anne Alinnor
Mary Irabor
Jennifer Ngufan Nongo
Idorenyin Diamond
Chioma Ada Nnah
Uju Stella Azubogu
Paul Ichendu Nsirimobu
Omosivie Maduka
Peace Opara
Rosemary Ogochukwu Ugwu
Datonye Dennis Alasia
Neonatal mpox in Nigeria: a case of transplacental or postnatal transmission
BMC Infectious Diseases
Neonatal Mpox
Nigeria
Transplacental transmission
Postnatal transmission
Monkeypox virus
Methicillin-resistant Staphylococcus aureus
title Neonatal mpox in Nigeria: a case of transplacental or postnatal transmission
title_full Neonatal mpox in Nigeria: a case of transplacental or postnatal transmission
title_fullStr Neonatal mpox in Nigeria: a case of transplacental or postnatal transmission
title_full_unstemmed Neonatal mpox in Nigeria: a case of transplacental or postnatal transmission
title_short Neonatal mpox in Nigeria: a case of transplacental or postnatal transmission
title_sort neonatal mpox in nigeria a case of transplacental or postnatal transmission
topic Neonatal Mpox
Nigeria
Transplacental transmission
Postnatal transmission
Monkeypox virus
Methicillin-resistant Staphylococcus aureus
url https://doi.org/10.1186/s12879-025-11362-y
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