Early use of oral tecovirimat successfully eases pain in two patients with monkeypox and severe proctitis

A case report suggests that early use of oral tecovirimat may be an effective treatment for patients with monkeypox and severe proctitis. The report is published in Annals of Internal Medicine.

Monkeypox illness includes systemic symptoms and skin eruptions, and more recent cases have involved proctitis with perianal lesions, some with severe anorectal pain. Researchers from George Washington University School of Medicine and Health Sciences describe monkeypox and its treatment in two patients with monkeypox and severe proctitis in the District of Columbia, which has the highest rate of infection per capita in the United States.

Both patients had rapid alleviation of rectal pain after starting treatment with oral tecovirimat with no serious adverse effects. While the authors could not determine the direct effect of tecovirimat in precipitating the rapid alleviation of the patients' symptoms, they believe that early use of tecovirimat should be considered for patients with monkeypox and severe proctitis until randomized controlled trials of tecovirimat can be done.

Reference:

Jose Lucar, Afsoon Roberts, Karl M. Saardi, et al; Monkeypox Virus-Associated Severe Proctitis Treated With Oral Tecovirimat: A Report of Two Cases. Ann Intern Med. [Epub 18 August 2022]. doi:10.7326/L22-0300