The patient, a 36-year-old Italian man, developed a range 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 surrounding a rash appeared on the man’s trunk, lower limbs, face and buttocks. By July 5, the vesicles had spread further and developed into pustules – small bumps on the skin – so the man was taken to a hospital in Palermo. There, he was tested for monkey pox and subsequently returned a positive result. 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 taken an HIV test last September and it came back negative. After recovering from Covid-19 and monkeypox, the patient was discharged from hospital on July 11 for home isolation. By this stage, his skin lesions had healed, after crusting over, leaving a small scar. “This case highlights how the symptoms of monkeypox and Covid-19 can overlap and confirms how in case of co-infection, souvenir collection and sexual habits are crucial for a correct diagnosis,” said researchers from the University of Catania. case report. “Of note, the oropharyngeal pox smear of the monkeys 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 not yet enough evidence to support that this combination can worsen the patient’s condition. Given the current SARS-CoV-2 pandemic and the daily increase in monkeypox cases, healthcare systems need to be aware of this possibility.”
