The study found important differences in symptoms between the current monkeypox outbreak and previous outbreaks in endemic regions, The BMJ writes. The findings are based on 197 confirmed cases of monkeypox at an infection center in London between May and July 2022. Some of the common symptoms they described, including rectal pain and genital swelling (edema), differ from those described in previous outbreaks. The researchers recommend that physicians consider the possibility of monkeypox infection in patients with these symptoms. Patients with confirmed monkeypox infection who have extensive genital lesions or severe rectal pain should be considered for ongoing surveillance or inpatient treatment. The majority (86%) of patients reported systemic disease (affecting the entire body). The most common systemic symptoms were fever (62%), swollen lymph nodes (58%), and muscle aches and muscle aches (32%). In contrast to existing case reports suggesting that systemic symptoms precede skin lesions, 38% of patients developed systemic symptoms after the onset of mucosal lesions, and 14% of patients had lesions without systemic signs. The authors note that solitary (single, isolated - ed.) lesions and swollen tonsils were not previously known as typical signs of monkeypox infection and could be mistaken for other diseases.