Monkeypox (mpox) is an orthopoxviral zoonotic disease with a similar but less severe clinical presentation as smallpox. However, immunocompromised patients such as solid organ transplant recipients are at higher risk of developing severe forms of the disease. Herein, we describe the case of a 43-year-old female kidney transplant recipient that manifested severe skin ulcers alongside nodular lung opacities and pleural effusion attributed directly to the monkeypox virus. Notwithstanding the initiation of early treatment with tecovirimat, a satisfactory response was not achieved until a reduction in immunosuppression to everolimus monotherapy, coupled with the transition to cidofovir for antiviral treatment. In conclusion, mpox has the potential to produce a severe form of systemic infection in individuals who have undergone solid organ transplantation, demanding a meticulous approach involving sequential antiviral treatment and modifications to immunosuppressive regimens in order to achieve complete healing.

中文翻译：

---

非 HIV 感染肾移植受者出现严重猴痘伴皮肤、肺和胸膜受累


猴痘 （mpox） 是一种正痘病毒性人畜共患疾病，其临床表现与天花相似但不太严重。然而，免疫功能低下的患者（如实体器官移植受者）患严重疾病的风险更高。在此，我们描述了一名 43 岁女性肾移植受者的病例，该病例表现为严重的皮肤溃疡以及直接归因于猴痘病毒的结节性肺混浊和胸腔积液。尽管开始使用 teovirimat 进行早期治疗，但直到对依维莫司单药治疗的免疫抑制减少，再加上过渡到西多福韦进行抗病毒治疗，才达到令人满意的反应。总之，mpox 有可能在接受实体器官移植的个体中产生严重的全身感染，需要采取细致的方法，包括序贯抗病毒治疗和修改免疫抑制方案，以实现完全愈合。