Graphic photos reveal how monkeypox left man’s nose rotting
A MAN’S nose rotted away due to monkeypox in a chilling case reported by doctors.
The 40-year-old was initially thought to have sunburn when he went to his GP with a red spot on the end of his nose.
But within three days the lesion developed to necrosis (tissue death).
A grim picture shows the German patient’s nose blackened and scabbed over, with a number of other blisters on his face.
The monkeypox virus causes a rash which at first looks similar to chickenpox.
It develops into firm, pus-filled blisters which later scab over.
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More than 35,000 cases of monkeypox have been reported in 92 countries, the World Health Organization said today.
The current outbreak is unusual because it had previously only been endemic in some African nations.
The vast majority of cases outside of Africa have been in men who have sex with men. The virus is spreading mostly through sexual activity.
Unusual case
The male patient, whose case was described in the journal Infection, first went to his GP complaining of a red spot on the tip of his nose.
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It was deemed to be sunburn. But the image published in the case report shows how rapidly his nose deteriorated within three days.
Necrosis is when the blood supply is cut off to body tissue, causing it to die. It cannot be reversed.
There were also lesions on the man’s face, penis and inside the mouth - which are typical areas affected by the rash.
Tests confirmed he was infected with monkeypox, but also revealed a surprising finding.
The man was positive for long-standing syphilis and HIV, of which he was not aware.
He had never had an STI check in his life, according to Dr Christopher Boesecke and colleagues.
It is not clear how long the man had HIV for without knowing. Typically HIV progresses to AIDS within eight to ten years, according to the Mayo Clinic.
At this point, the immune system is severely damaged and a patient is more likely to become very unwell with illnesses that a healthy person would not.
The man was treated with tecovirimat, branded Tpoxx, an antiviral medication being used to treat monkeypox patients.
But doctors did not give an update on his state, other than to say "the monkeypox lesions on the skin dried out and the nose partially improved with less swelling".
Because the man had uncontrolled HIV, his immune system was weaker, which would have raised his risk of severe complications.
It is therefore unlikely that someone without HIV would suffer such complications, with the illness generally described as “mild”.
And controlled HIV does “not appear to be a risk factor” for severe illness, the authors reassured.
However, a HIV patient who is on medication recently told The Sun of his monkeypox infection - and how it started with a red spot on his nose.
Harun Tulunay, a 35-year-old charity worker, developed a red and white rash on his body that resembled an allergic reaction, which he said was “nothing like the monkeypox pictures you see online”.
It wasn’t until a few days later that he also noticed a painless spot on his nose which he assumed was a mosquito-like bite or pimple.
Harun is living with HIV and takes medication which reduces the amount of HIV in his blood to a very low level, which keeps his immune system working and prevents illness.
His blood tests suggested he had a robust immune system at the time of his monkeypox infection.
However, his GP suggested that his symptoms may be an indication that his medication isn’t working, which Harun said was “really scary”.
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Huran had a sore throat and swollen tonsils that made it difficult to breathe, swallow or speak, and he said he’d “never been in so much pain in his life”.
The lesion on his nose became infected but, thankfully, it has fully recovered.
Spot the signs of monkeypox
At first, between five and 21 days after exposure, you'll show symptoms similar to the flu.
These are:
- A high temperature
- A headache
- Muscle aches
- Backache
- Swollen glands
- Shivering (chills)
- Exhaustion
- Joint pain
A rash usually appears one to five days after the first symptoms.
Typically with monkeypox, the rash often begins on the face, then spreads to other parts of the body. This can include the mouth, genitals and anus.
Experts have said that in this outbreak, genital lesions are more common than they usually are.
And lesions tend to be grouped in one area, for example the anus.
The rash can initially look like pimples or blisters and may be painful or itchy.
When the bumps fill with clear fluid, this is known as the vesicular stage. The bumps are firm and do not break easily.
During the pustule stage, the clear liquid inside the blisters becomes yellowish and then an indent will form in the centre (umbilicated).
This stage can last for five to seven days before the lesions begin to crust over.
The symptoms of monkeypox tend to clear up within two to three weeks all together.
The Centre for Disease Control and Prevention warns that monkeypox can be spread from the time symptoms start until the rash has healed, all scabs have fallen off, and a fresh layer of skin has formed.