An Italian man has become the first person known to have tested positive for monkeypox, Covid-19 and HIV at the same time, scientists have revealed. The 36-year-old's triple infection was discovered after he took ill following a five-day holiday to Spain.
The man, who was double vaccinated against COVID, spent five days in Spain from June 16 to June 20 and nine days later came down with a temperature of 39C, accompanied by sore throat, fatigue, headache and pain in his groin, The Independent reported. He first tested positive for Covid on 2 July, according to a case study report published in the Journal of Infection.
The following day small, painful spots surrounded by red rings appeared on the man’s body, legs, face and bottom. Two days on, the spots had become pustules and the man went to a hospital in Palermo for treatment.
He was tested for monkeypox and subsequently returned a positive result. The patient was also screened for multiple sexually transmitted infections. 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 taken an HIV test in September of last year and returned a negative result. He told doctors that while in Spain, he had had unprotected sex with men.
After recovering from Covid-19 and monkeypox, the patient was discharged from hospital on July 11 to his home. By this stage, his skin lesions had healed, after crusting over, leaving a small scar. He is being given combination drug therapy for his HIV infection.
The researchers who reported on the case said it was important to be aware that patients who have Covid-19 might also be infected with monkeypox. “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,” the team, from the University of Catania, said in their case report.
“To note, the monkeypox oropharyngeal (throat) swab was 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 monkeypox virus, SARS-CoV-2 and HIV co-infection, there is still not enough evidence supporting that this combination may aggravate 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.”
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