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Volume 29, Number 6—June 2023
Research Letter

Isolated Ocular Mpox without Skin Lesions, United States

Minh T. Nguyen, Akshay Mentreddy, Julie Schallhorn, Matilda Chan, Su Aung, Sarah B. Doernberg, Jennifer Babik, Kevin Miles, Katherine Yang, Emily Lydon, Daniel J. Minter, John Gonzales, Jessica Shantha, Thuy Doan, and Gerami D. SeitzmanComments to Author 
Author affiliations: University of California, San Francisco, California, USA (M.T. Nguyen, A. Mentreddy, J. Schallhorn, M. Chan, S. Aung, S.B. Doernberg, J. Babik, K. Miles, K. Yang, E. Lydon, D.J. Minter, J. Gonzales, J. Shantha, T. Doan, G.D. Seitzman); Francis I. Proctor Foundation, San Francisco (M.T. Nguyen, A. Mentreddy, M. Chan, J. Gonzales, J. Shantha, T. Doan, G.D. Seitzman)

Main Article

Table

Summary of laboratory and microbiology testing of patient with ocular mpox, California, USA

Test Result
Laboratory and microbiology testing from serum or ocular surface scraping or swab specimen
Human leukocyte antigen B27 Negative
Angiotensin-converting enzyme Within reference range
Complement Within reference range
Antineutrophilic cytoplasmic antibody Within reference range
Antinuclear antibodies Within reference range
Rheumatoid factor Within reference range
Anti-cyclic citrullinated peptide Within reference range
HIV antibody/antigen Negative ×2
QuantiFERON-TB Gold* Negative
Fluorescent treponemal antibody absorption Negative ×2
Herpes simplex virus 1 DNA from ocular surface swab specimen Negative ×2
Cytomegalovirus DNA from ocular surface swab specimen Negative ×2
Varicella zoster virus DNA from ocular surface swab specimen Negative ×2
Bacterial culture on blood, chocolate, Middlebrook agar Negative ×2
Fungal culture on potato flake agar Negative ×2
Monkeypox virus RNA from aqueous sample Positive for MPXV
Monkeypox virus DNA from conjunctival swab specimen
 Positive ×5
Testing from scleral and corneal biopsy
Periodic acid Schiff for fungus Negative for fungal organisms
Grocott’s methamine silver Negative for fungal organisms
Steiner Negative for spirochetes
Acid-fast bacteria (Fite)† Negative for acid-fast organisms
Trepona pallidum antibody Negative
Herpes simplex virus 1 & 2 Negative
Varicella zoster virus
Negative
Complete blood count with differential obtained at the time of hospitalization
Red blood cell count (reference 4.4–5.9 ×1012 cells/L) 4.45 × 1012 cells/L
Hemoglobin (reference 13.6–17.5 g/dL)‡ 13.7 g/dL
Platelets (reference140–450 ×109/L)‡ 174 × 109/L
Leukocyte count (reference 3.4–10 ×109 cells/L) 4.3 × 109 cells/L
Absolute neutrophils (reference 1.8 × 6.8 × 109 cells/L) 3.93 × 109 cells/L
Absolute monocytes (reference 0.2–0.8 ×109 cells/L)‡§ 0.06 × 109 cells/L
Absolute eosinophils (reference 0–0.4 ×109 cells/L) 0
Absolute basophils (reference 0–0.1 × 109 cells/L) 0.01 × 109 cells/L
Absolute lymphocytes (reference 1–3.4 × 109 cells/L)‡§ 0.33 × 109 cells/L

*QIAGEN, https://www.qiagen.com. †Newcomer Supply, https://www.newcomersupply.com/product/afb-fite-stain-kit. ‡Hemoglobin (>10 g/dL) and platelet count (>100 × 109/L) do not meet criteria for active chronic lymphocytic leukemia and treatment. §Indicates chronic lymphocytopenia.

Main Article

Page created: April 26, 2023
Page updated: May 18, 2023
Page reviewed: May 18, 2023
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
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