Italian Man With Fever Learns He Has Monkeypox, Covid-19, and HIV All at Once

A 36-year-old man in Italy appears uniquely unlucky, after being hospitalized and diagnosed with Covid-19, monkeypox and HIV over a period of a week in July. Thankfully, his covid and monkeypox co-infection ended successfully without any problems, and he has since been put on HIV treatment.

His doctor narrates this unfortunate medical story in a Case Report Published last week in the Journal of Infection. According to the report, on June 29, nine days after returning from a trip to Spain, the man first fell ill with fever, sore throat and headache. On July 2, he tested positive for the SARS-CoV-2 coronavirus, but on the same day, he noticed that a rash began to develop on his left arm. Over the next few days, the rash turned into small, painful blisters that spread to his face, trunk, lower limbs, and glutes. On 5 July, he sought care at the emergency department of a local hospital in Catania, Italy, where he was then admitted to the infectious disease unit.

Given the man’s symptoms and recent travel to Spain, doctors quickly suspected monkeypox infection and collected samples for testing (the country was one of the first to report cases this year). While in Spain, the man also reported having condomless sex with other men, which has been a risk factor for monkeypox during the current outbreak. Finally, on July 6, the man tested positive for monkeypox, HIV, and the coronavirus – specifically, Omicron ba.5.1 ed.

“To date, there have been no published reports of co-infection with monkeypox virus and SARS-CoV-2,” the authors wrote. “Therefore, in this study we present the clinical features and diagnostic procedure of the first documented case of co-infection with monkeypox virus, SARS-CoV-2 and HIV-1.”

Because of their respective incubation periods, man could catch the coronavirus and monkeypox at the same time. It is thought to take it from anywhere three to 17 days in and around after monkeypox symptoms appear two to 14 days To show COVID-19 symptoms (although there is a possibility of an incubation period shortened on average for Omicron). As far as HIV infection is concerned, the man told the doctors that he tested negative for it in September 2021. And since her CD4 lymphocyte count was still normal, it is likely that the infection was caught recently as well. it can take 10 to 90 days Depending on the test used, and initial flu-like symptoms may appear within a few weeks to a month after exposure, the person tests positive for HIV.

Although co-infections can sometimes contribute to more severe disease, it is not clear whether this played a role in this case. By the third day after the man is hospitalized, most A crust began to form on his rash; By the fifth day, his symptoms had almost completely recovered and he was soon sent home. By July 13, he was no longer testing positive for the coronavirus, and on July 19, a follow-up visit to doctors revealed that his crusty rash had almost completely healed, although he was still on a swab test. Was positive for monkeypox. He was also started on a standard combination therapy for HIV that, when taken regularly, is known to be very effective at keeping chronic infections at bay.

While monkeypox can be spread to others through any kind of prolonged close contact, evidence suggests that the majority of cases occurred during this outbreak. transmitted during sexand more commonly in gay and bisexual men who have recently had multiple partners—perhaps both from close contact with an infectious rash and through infectious semen or other bodily fluids, Because the COVID-19 pandemic is still ongoing and cases of monkeypox are on the rise, the authors say, doctors should be aware of the possibility of co-infection in high-risk groups. They also say that their case emphasizes the major role of sex in spreading monkeypox.

“Therefore, full STI screening is recommended following a diagnosis of monkeypox,” they wrote.