A 36-year-old Italian man tested positive for COVID-19, monkeypox, and HIV all at the same time after returning from a short trip in Spain.
According to the case report published in the Journal of Infection last week, the man, who has not been identified, developed fever, a sore throat, fatigue, headache and inflammation in his groin area nine days after returning from a five day trip in Spain.
Even though the patient had been vaccinated with two doses of the Pfizer COVID-19 vaccine in 2021 and had contracted the virus in January 2022, he tested positive for COVID-19 on July 2 and began developing a rash the same day.
The day after, small, painful blisters appeared on his torso, lower limbs, face and rear. By July 5 the blisters spread and developed into pustules with a depression in the middle of them. The man decided to go to the emergency room at the University Hospital in Catania, Italy and was transferred to the Infectious Diseases unit.
After he was admitted, the patient reported that he had unprotected sex with men while he was in Spain. He tested positive for monkeypox and several STI tests also came back positive for HIV.
His white blood cell count was relatively unchanged which led scientists to assume that the HIV infection “was relatively recent.”
“This case highlights how monkeypox and COVID-19 symptoms may overlap, and corroborates how in case of co-infection, anamnestic collection and sexual habits are crucial to perform the correct diagnosis,” researchers said.
They added that sexual intercourse could be the predominant way of transmission so if a patient presents with symptoms consistent with a monkeypox infection, they recommend a complete STI screening after diagnosis.
However, since this is the only reported case of monkeypox, COVID, and HIV altogether, it is not clear if the combination may aggravate a patient’s condition.
“Given the current SARS-CoV-2 pandemic and the daily increase of monkeypox cases, healthcare systems must be aware of this eventuality, promoting appropriate diagnostic tests in high-risk subjects, which are essential to containment as there is no widely available treatment or prophylaxis,” researchers said.
The man was discharged from the hospital on July 11.
