Patient: [Patient Name]
MRN: [Medical Record Number]
Date: [Date of Encounter]
Chief Complaint:
New or suspected monkeypox virus infection
(Specify) Symptoms may vary but can include:
Fever
Headache
Muscle aches
Backache
Swollen lymph nodes
Fatigue
Chills
After a few days: development of a rash that starts as flat red bumps and progresses to fluid-filled blisters (pustules) that eventually crust over and fall off
History of Present Illness:
Onset, duration, and severity of symptoms.
Progression of the rash (location, number of lesions, stage of development).
Travel history to areas with monkeypox cases in the past 3 weeks.
Close contact with someone diagnosed with monkeypox in the past 3 weeks.
Occupational exposure to monkeypox virus (e.g., healthcare workers).
Past Medical History:
Underlying medical conditions that may increase risk of complications (immunodeficiency, pregnant or breastfeeding).
History of vaccination (vaccination against smallpox may provide some protection).
Medications:
List all current medications.
Social History:
Recent close contact with individuals who may be at higher risk for monkeypox (travelers to endemic areas, men who have sex with men).
Family History:
Family history of monkeypox (unlikely).
Physical Exam:
Vital signs: Assess for fever, tachycardia (rapid heart rate).
General examination: Assess for overall appearance and signs of illness.
Skin examination:
Describe the rash (location, number of lesions, stage of development).
Look for lesions on the face, palms, and soles (can be atypical).
Lymph node examination: Look for swollen lymph nodes, particularly in the groin or neck.
Laboratory Tests:
Monkeypox virus PCR test: The definitive test for diagnosing monkeypox using a swab from a skin lesion.
Complete blood count (CBC): May show abnormalities in white blood cell count.
Imaging Studies:
Not routinely needed for diagnosis.
Assessment:
Suspected monkeypox virus infection: Based on clinical presentation (fever, rash) and epidemiology (travel history, close contact).
Confirmation of monkeypox virus infection: Requires a positive monkeypox virus PCR test.
Differential Diagnoses:
Consider other conditions with similar rash presentations, such as:
Varicella-zoster virus (chickenpox)
Herpes simplex virus
Bacterial skin infections
Syphilis
Plan:
Isolation: Patients with suspected or confirmed monkeypox should isolate at home or in a healthcare facility to prevent spread.
Supportive care: Manage symptoms with medications for fever, pain, and itching.
Treatment: Tecovirimat (Tpoxx) is an antiviral medication that may be considered for treatment, especially in high-risk patients or those with severe disease.
Vaccination: Vaccination with Jynneos (vaccinia virus) may be offered to close contacts or individuals at high risk for exposure to prevent infection or lessen disease severity.
Public health reporting: Report suspected or confirmed cases to local public health authorities to facilitate contact tracing and control measures.
Patient education:
Provide information about monkeypox transmission, symptoms, and prevention strategies.
Instruct on proper hygiene and wound care to prevent spread.
Advise on remaining isolated until lesions have crusted over and fallen off.
Follow-up: Schedule follow-up visits to monitor symptom resolution and ensure complete recovery.
Disclaimer: This template is for informational purposes only and should be adapted to the specific needs of each patient. Monkeypox is a viral illness with a characteristic rash. Early diagnosis, isolation, and supportive care are crucial to prevent transmission and manage symptoms.