We have been covering the global outbreak of monkeypox, which seems to have accelerated after June’s month of gay pride festivities. Given that research points to the disease being linked to sex between men (or those who at least have all the man parts), this is perhaps not too surprising.
Most infected have recovered in full, despite dealing with extremely painful lesions and flu-like symptoms. However, recent cases underscore how severe infection can be in those with a challenged immune system.
An article in the Journal of Infection reports the case of an Italian man who tested positive for covid, monkeypox, and HIV all at once in July after having unprotected sex during a trip to Spain. He becomes the first recorded patient who has hit the trifecta of these three viruses.
The patient in the case report, an Italian 36-year-old male, spent five days in Spain in June. Nine days after returning home from his trip, he developed a fever, sore throat, fatigue, headache and inflammation in his groin area. Shortly afterward, he tested positive for SARS-CoV-2 and within a day he developed a rash on his left arm. The day after, small, painful blisters appeared on his torso, lower limbs, face and rear.Due to the spread of the blisters that began to evolve into pustules with a depression in the middle of them, he decided to go to the emergency room of the Policlinico “G. Rodolico – San Marco” University Hospital in Catania, Italy and was transferred to the Infectious Diseases unit at the hospital.After being admitted, the patient reported that he had unprotected sex with men during his stay in Spain. He was tested for monkeypox and tested positive for the West African variant of the virus, which has been found to be responsible for the outbreak in Spain. Even after 20 days, monkeypox tests continued to return positive, with the physicians stressing that this could mean that patient may remain contagious for several days after clinical remission.
A copy of the journal article can be found HERE.
Next, a German man’s nose decayed after his monkeypox infection was exacerbated by an undiagnosed case of HIV paired with syphilis.
A report in the medical journal Infection said that the 40-year-old man originally visited his general practitioner for a red spot on his nose, which he was told was sunburn.But the man eventually developed necrosis — a condition where body tissue dies — when the red spot turned into dry, crusty skin that began to darken at the tip.The man developed skin lesions around his face, body and genitals as his nose worsened. That’s when he tested positive for monkeypox, and doctors subsequently found out he had an advanced HIV infection and a long-duration syphilis infection.While a majority of monkeypox cases are mild, the report’s authors note that “This case illustrates the potential severity of [a monkeypox] infection in the setting of severe immunosuppression and untreated HIV infection.”
The article from Infection is posted HERE.
Both of these cases underscore why worrying about the name of a virus and stigma are substantially less important than being candid about modes of transmission and relative risk.
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