Mpox, previously termed monkeypox, is an orthopoxvirus infection predominantely spread through sexual contact. In 2022 a global outbreak led to its declaration as a Public Health Emergency of International Concern by the WHO, with over 78,000 cases across 100 countries. (76) This outbreak disproportionately affected PLWHIV, who comprised approximately 40% of diagnosed cases. (77) To date, over 140 cases have been reported in Australia since May 2022. (78) 

Clinical Presentation 

Patients with mpox typically present with 2-5mm painful umbilicated papules and pseudopustules (containing solid debris rather than pus),  typically affecting anogenital and perioral sites in the 2022 outbreak. (76, 79) Systemic symptoms such as fever, fatigue and headache may be present. Palpable lymphadenopathy may be detected on examination in up to 90% of cases. In PLWHIV, clinical manifestations may not differ substantially to people without HIV, (80, 81) however those with advanced immunodeficiency are at higher risk of disseminated rash, hospitalisation and death. (82)