LAUSR

CASE A 50-year-old man with HIV presented with an isolated dorsal index finger abscess. He underwent incision and debridement, but no pus was encountered. Surgical pathology demonstrated pox virus features. He then developed body pustules confirmed as monkeypox through polymerase chain reaction. The surgical wound deteriorated, prompting a second debridement of necrotic skin. Vesicles consistent with viral infection then appeared. The finger healed with local wound care within 3 months, achieving excellent function. CONCLUSION This case illustrates an uncommon presentation of monkeypox, resembling a bacterial infection before vesiculation. Early recognition of monkeypox is critical to avoid unnecessary surgery.