The diagnostic dilemma for atypical presentation of progressive human Mpox

Background: Human mpox has increasingly been reported worldwide since May 2022, with higher incidence in men who have sex with men (MSM) and persons living with HIV (PLHIV) with presentation typical for generalized macules and papules.

Case presentation: We are describing a case of human mpox, which presented as widespread, atypical round verrucous lesions that went undiagnosed in the community for six months and was treated with antibacterials and antifungals given the similarity to skin manifestations associated with endemic mycoses.

Conclusions: Suspicion for human mpox should be high in young MSM and PLHIV who present with rash and mpox should be ruled out earlier.