Mpox With Digestive Manifestations in a 16‐Year‐Old Adolescent Girl: A Case Report

Mpox, primarily known for cutaneous and mucosal manifestations, can present atypically. This case reports a rare digestive form with peritonitis in a 16-year-old girl. A febrile adolescent presented with acute abdominal pain, peritonitis, systemic inflammation, anemia, and ionic disturbances. Imaging revealed intra-abdominal effusion, and polymerase chain reaction (PCR) confirmed Mpox virus infection in surgical specimens. The diagnosis was confirmed by PCR performed on intraoperative pus, targeting the F3L gene of the <i>Orthopoxvirus</i> genus. The test was processed at the National Institute for Biomedical Research (INRB, Goma). The result was positive, with a cycle threshold (Ct) value of 24. Peritonitis was attributed to Mpox. Laparotomy showed fatty nodules and a retrouterine purulent collection. Management included surgery, antibiotic (erythromycin) therapy, ionic correction, and intensive care, leading to recovery by Day 30. This case highlights a severe, atypical Mpox presentation, emphasizing its inclusion in the differential diagnoses of acute surgical abdomen during outbreaks. Early diagnosis and multidisciplinary care are crucial, warranting further study on Mpox's digestive tropism.