What are the key clinical features to consider when diagnosing Mpox in a primary care setting?

When diagnosing Mpox in a primary care setting, key clinical features to consider include an initial prodromal phase characterized by fever, malaise, headache, and lymphadenopathy, which is a distinguishing feature from other similar infections NICE NG206. Following this, a characteristic rash typically develops, progressing through macular, papular, vesicular, and pustular stages before crusting and healing. The rash often begins on the face and then spreads centrifugally to the trunk, limbs, and sometimes the palms and soles NICE NG206. Lymphadenopathy, particularly in the cervical, axillary, or inguinal regions, is a prominent and early sign that helps differentiate Mpox from chickenpox or smallpox NICE NG206. In addition, recent literature highlights that lesions may be painful and can involve mucosal surfaces, including the oral cavity and genitalia, which is important to note in clinical assessment Dashraath et al. 2022. The presence of systemic symptoms such as fever and lymphadenopathy preceding the rash, combined with the characteristic lesion progression and distribution, should raise suspicion of Mpox in patients presenting in primary care, especially if there is relevant epidemiological exposure or travel history NICE NG206 Dashraath et al. 2022.