• Large brick¬ shaped particles
  • Replicates and matures within cytoplasm of host cell
  • Two distinct genetic clades of monkeypox virus – the Central African (Congo Basin) clade and the West African clade
  • Congo Basin clade has historically caused more severe disease and was thought to be more transmissible
  • Prodrome (1-5 days):
    • Fever
    • Lymphadenopathy
    • Intense headache
    • Myalgia
    • Backpain
    • Lethargy
  • Skin involvement (2-4 weeks):
    • Face and extremities (95%)
    • Palms & soles (75%)
    • Oral mucosa (70%)
    • Genitalia (30%)
    • Conjunctivae (20%)
  • Management
    • Supportive care
    • Antivirals
    • Tecovirimat
    • Brincidofovir/ Cidofovir
    • Immunoglobulins -Vaccinia immune globulin (VIG)


A 16-year-old male presented with a history of easy fatigability for 6 yrs, distension of the abdomen, and pedal edema for 4 yrs . Palpitation is intermittent, irregular, and associated with diuresis. On examination, raised JVP with hepatojugular reflux +, Kussmaul sign +.On CVS examination, S1 S2 (A2P2) heard, normal split, low pitched pan systolic murmur best heard at the left parasternal border at 4th intercostal space. In the Per Abdomen examination, distended abdomen with hepatomegaly (liver span 16 cm, firm & smooth), shifting dullness +, bowel sounds heard. In the hemogram, the Total eosinophil count is high. The images of 2 D Echo and Cardiac MRI have been shown. What is the diagnosis?


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