Infection with the monkeypox virus (MPXV) causes a clinical disease comparable to smallpox but with marked lymphadenopathy. However, symptoms and severity are typically much less severe . Systemic symptoms such as fever, lethargy, myalgia, headache, and lymphadenopathy are common; later infection develops a rash, anogenital lesions, and mucosal lesions that evolve into vesicular-pustular lesions . After healing, pigmentation and scarring may persist. Patients are considered infectious until lesions crust over, fall off, and are replaced by a new layer of skin or mucous membranes. Lesions on the skin and inside of the mouth and nose can look like syphilis, varicella-zoster, herpes simplex, molluscum contagiosum, or an acute HIV infection .