Dear Editor:

We would like to share ideas on the article “Monkeypox in a Kidney Transplant Recipient: Case Report and Literature Review” from Alalawi and colleagues.1 The virus known as monkeypox (mpox) is normally not serious, but kidney transplant recipients may be more vulnerable to consequences because of their compromised immune systems. On the other hand, little is known about the prognosis and clinical course of mpox in recipients of transplants. Only 2 examples have been documented, to our knowledge; one patient had complications but recovered totally, and the other patient had complications but recovered fully as well. In their case report, Alalawi and colleagues described a 46-year-old male kidney transplant patient who experienced fever, sore throat, and skin rash. Although the patient had not recently traveled or had come into contact with mpox cases, DNA testing verified the infection. After the patient received supportive treatment, he made a full recovery. This report highlights how crucial it is to rule out mpox in immunocompromised individuals with skin rashes and how quickly a diagnosis may be made by identifying the condition early using viral detection.

The information gap about the long-term prognosis and possible complications of mpox in transplant recipients is currently the weak point. Furthermore, the general understanding of the condition is limited because of the rarity of documented cases. More information on mpox cases in transplant recipients is needed to help understand the disease’s clinical course, potential complications, and long-term effects. Larger-scale research or case studies with a particular focus on this population could accomplish this. Furthermore, studies on immunization and other preventive strategies in high-risk populations, such as transplant patients, could be conducted. Because coinfection may make interpretation of a patient’s clinical presentation difficult, it is imperative to take other coinfections into account in cases of mpox.²

References:

1. Alalawi F, Alhadari F, Tobia H, Alhadari A. Monkeypox in a kidney transplant recipient: case report and literature review. Exp Clin Transplant. 2023;21(11):913-916. doi:10.6002/ect.2023.0222.
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2. Mungmunpuntipantip R, Wiwanitkit V. Monkeypox in HIV infected cases: a summary on clinical presentation of 27 cases. Infect Chemother. 2022;54(3):549-550. doi:10.3947/ic.2022.0104
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