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 Orthopoxvirus 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.