Scientists have reported the first known case of a person testing positive for monkeypox, Covid-19 and HIV at the same time.
The patient, a 36-year-old Italian man, developed a series of symptoms, including fatigue, fever and sore throat, nine days after returning from a trip to Spain where he had unprotected sex.
He first tested positive for Covid on July 2, according to a case study report published in the Journal of Infection.
The next day, small painful blisters appeared surrounded by a rash on the man’s torso, lower limbs, face and buttocks. On July 5, the vesicles had spread even further and turned into pustules – small bumps on the skin – at which point the man was transferred to a hospital in Palermo.
There, he was tested for smallpox and later tested positive.
The patient was also screened for multiple STIs. He tested positive for HIV-1, and the researchers said that “given his preserved CD4 count, we could assume that the infection was relatively recent.”
The patient had been tested for HIV in September last year and it came back negative.
After recovering from Covid-19 and monkeypox, the patient was discharged from hospital on July 11 to self-isolate at home. By this stage, his skin lesions had healed, having been scraped off, leaving a small scar.
“This case highlights how the symptoms of monkeypox and Covid-19 can overlap, and corroborates how in case of co-infection, anamnestic collection and sexual habits are crucial to make the correct diagnosis,” said the researchers from the University of Catania in their publication. case report
“Of note, oropharyngeal swabs from monkeypox were still positive after 20 days, suggesting that these individuals may still be contagious for several days after clinical remission,” the report said. “Consequently, physicians should encourage appropriate precautions.”
The researchers added: “As this is the only reported case of co-infection by monkeypox virus, SARS-CoV-2 and HIV, there is still insufficient evidence to support that this combination can exacerbate the condition of the patient. Given the current SARS-CoV-2 pandemic and the daily increase in monkeypox cases, healthcare systems must be aware of this eventuality.”