A 36-year-old man in Italy was hospitalized and diagnosed with covid-19, monkeypox, and HIV in a single week. He was placed on HIV treatment after his covid and monkeypox co- infections were successfully cleared.
This unfortunate medical tale was described in a case report by his doctors. Nine days after returning from a trip to Spain, a man became unwell with a sore throat, headaches, and a high temperature. He had a rash on his left arm after he tested positive for the coronaviruses. The blisters that spread along his face, torso, and lower limbs were caused by the rash. He was admitted to the infectious disease unit at the local hospital in Sicily after seeking care at the emergency department.
The country was one of the first to report cases this year due to the man's symptoms and travel to Spain. During his time in Spain, the man had condomless sex with other men, which is a risk factor for monkeypox. On July 6th, the man tested positive for monkeypox, HIV, and the coronaviruses.
There have been no reports of co-infection with monkeypox virus and the new coronaviruses. In this study we present the clinical features and diagnostic procedure of the first documented case of co-infection with three different Viruses.
The man could have caught the two diseases at the same time. It is thought to take anywhere from three to 17 days after exposure for monkeypox symptoms to appear, and around two to 14 days for covid 19 symptoms to show up. The man told doctors that he did not have the HIV infection. Since his CD4 lymphocyte count was normal, it is likely that this was caught recently. It can take 10 to 90 days after exposure to test positive for HIV, depending on the test used, and flu-like symptoms can appear within a few weeks.
It is not clear if co-infections played a role in this case. By day three of the man's hospitalization, most of his rash was gone, and by day five, his symptoms had almost completely gone away. By July 13, he was no longer positive for the coronaviruses, and a follow-up visit to the doctors revealed that his rash had healed completely, though he was still positive for monkeypox. A standard combination therapy for HIV is known to be very effective at keeping the chronic infections at bay.
Evidence shows that the majority of cases during this outbreak have been transmitted during sex by gay and bisexual men who have had multiple recent partners. The authors say that doctors should be aware of the possibility of co-infection in high-risk groups because of the ongoing covid-19 epidemic. The case emphasizes the main role that sex could be playing in the spread of monkeypox.
After a diagnosis of monkeypox, complete STI screening should be done.
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