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Hospital Clínic Barcelona, Barcelona, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "En respuesta a la carta al director «Comentarios a: Manifestaciones otorrinolaringológicas en la viruela del mono»" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">First of all, thank you for your response to the article published in the <span class="elsevierStyleItalic">Acta Otorrinolaringológica Española</span> on ENT manifestations of monkeypox.</p><p id="par0010" class="elsevierStylePara elsevierViewall">Numerous epidemiological measurements and indicators can help us describe the impact of a disease on the population. We agree with the author's assessment that it would have been more accurate to use cumulative incidence instead of prevalence. Cumulative incidence quantifies the proportion of new cases of the disease that appear during a follow-up period in a population which did not have the disease at the beginning of the period studied. In our case, prevalence was used to compare it with the data offered by the WHO on the different countries analysed.</p><p id="par0015" class="elsevierStylePara elsevierViewall">Regarding the tonsillitis that the author comments on, it is worth emphasizing, as described in the article, that tonsillitis in the patients studied was the main and only manifestation of monkeypox infection in all but 2 patients who had skin lesions on the nasal dorsum. All of them were diagnosed by PCR from the smear of the pharyngeal lesions exclusively. We agree with the author that it would have been interesting to have performed bacterial smears of the lesions to rule out other concomitant infections but, unfortunately, in our case these were not done.</p><p id="par0020" class="elsevierStylePara elsevierViewall">As the author highlights, up to 50% of patients have microorganism-associated infections, and in our series 2 cases of co-infection with sexually transmitted diseases diagnosed in the days prior to the consultation are described. This fact supports the importance of epidemiological risk factors that could indicate monkeypox infection being described in the literature, and should help us suspect its diagnosis.</p><p id="par0025" class="elsevierStylePara elsevierViewall">The author emphasizes the importance of considering the diagnosis of monkeypox in patients who present an exclusive oro-tonsillar manifestation. We could not agree more in the assessment and it was one of the reasons that led is to describe our case series. It should be noted that this disease occurs in most cases in epidemic outbreaks, so it is important to be especially alert when these occur.</p><p id="par0030" class="elsevierStylePara elsevierViewall">To conclude, we agree that knowledge regarding ENT manifestations of the disease for an early diagnosis by an ENT specialist is highly important, as are the possible systemic manifestations described in Table 1 of the article and in the case published by Correira de Oliveira et al. al.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a></p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:1 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Oropharyngeal and laryngeal manifestations of human monkeypox" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "M. 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Journal Information
Vol. 75. Issue 2.
Pages 135 (March - April 2024)
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Vol. 75. Issue 2.
Pages 135 (March - April 2024)
Letter to the Editor
In response to the letter to the editor “Comments to: Manifestations ENT manifestations in monkeypox”
En respuesta a la carta al director «Comentarios a: Manifestaciones otorrinolaringológicas en la viruela del mono»
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