Penile necrosis due to monkeypox

Since 2022 Monkeypox virus (MPXV) infection incidence of cases has increased. Genitourinary lesions and penile edema are one of the main causes of emergency room visits. We aim to describe a 36-year-old man with MPXV infection and newly diagnosed with HIV and low CD4+ count, who developed a rapidly extensive penile necrosis. Extensive surgical debridement was performed and necrosis compromise was confirmed in the histopathological findings. We provide novel forms of presentation of MPXV, improving data collection and awarding health workers for a correct differential diagnosis.