Monkeypox Infection in Kidney Transplant Recipients

BACKGROUND: The monkeypox virus is currently circulating in Africa and has been declared a public health emergency of international concern. Due to lifelong immunosuppressive therapy, kidney transplant recipients are susceptible to infections and at high risk for developing serious complications. SUMMARY: We summarized the clinical data of 11 patients from the database. A total of 10 cases occurred in males, with age ranging from 25 to 62 years old. Common clinical features include rashes, anorectal pain, fever, pharyngitis, diarrhea, dyspnea and abdominal pain. Median duration of symptoms at presentation was 54 days (range, 21-120 days). Once diagnosed, immunosuppressive agents were adjusted among seven patients (7/11). A total of 10 cases received antiviral medication including tecovirimat, cidofovir and brincidofovir. The median time to initiate treatment was 16.5 days (range, 4-35 days). The majority (10/11) had a good prognosis, with one monkeypox-related death in the cohort. KEY MESSAGES: Monkeypox infection is spreading fast over the world and presents a major concern to kidney transplant recipients. In this immunocompromised group, we should focus more on effective preventative and treatment techniques. Further research is needed to standardize management algorithms.