The current outbreak of monkey pox which affects more than 96 countries, has shown common cases of co-infection between the disease caused by the monkeypox virus and other sexually transmitted diseases, such as syphilis and herpes.
According to the World Health Organization (WHO), among the cases of monkeypox registered in the world where there is identification of serology for HIV, 45% are positive. The data are included in the WHO epidemiological bulletin released on Wednesday (24).
Doctors at the University of Catania, Italy, described the first case of a patient who had a coinfection with the monkeypox, HIV and SARS-CoV-2 viruses, which causes Covid-19. The clinical findings were published in the scientific journal Journal of Infectionon the 19th of August.
case details
According to the study, the patient is a 36-year-old Italian man who spent five days in Spain between June 16 and 20. Nine days after the trip, he developed a high fever, accompanied by a sore throat, fatigue, headache, and enlarged lymph nodes – common symptoms of monkeypox.
On July 2, the man tested positive for Covid-19. On the afternoon of the same day, the first signs of skin lesions appeared on the patient’s left arm. The next day, small painful blisters appeared on the trunk, legs, face and buttocks.
With a progressive increase in the blisters, which began to evolve into pustules, which are those with the presence of pus, the man sought medical attention at the emergency department of the University Hospital of Catania, from where he was later transferred to the infectious diseases unit.
According to the study, the patient reported being treated for syphilis since 2019 and having tested negative for HIV in September 2021. In addition, he stated that he took daily medication for the treatment of bipolar disorder. The patient, who received two doses of the Pfizer vaccine, said he also contracted Covid-19 in January. At the consultation, he claimed to have had sex without a condom with men during his stay in Spain.
With signs of fever, fatigue, headache and pharyngeal pain, the man had skin lesions at different stages of progression, a characteristic that has been observed in several cases in the current outbreak, according to infectious disease specialists.
Physicians collected samples of skin lesions and nasopharyngeal secretions, which were processed by the Regional Reference Laboratory at the university hospital. Molecular diagnostic tests and sequencing revealed the presence of the monkeypox virus, of the viral group (or clade) II, associated with the outbreak in Spain, and of the Ômicron (BA.5) lineage of the coronavirus.
full investigation
Based on the patient’s reported history, doctors also performed screening tests for other sexually transmitted infections (STIs). Serologies for viral hepatitis, herpes simplex, gonorrhea, chlamydia and lymphogranuloma venereum were negative. However, the HIV test was positive with a viral load of 234 thousand copies/mL.
“This case highlights how the symptoms of monkeypox and Covid-19 can overlap and corroborates how in the event of co-infection, anamnestic collection (listening to the patient’s history) and sexual behaviors are crucial to making the correct diagnosis. ”, say the researchers in the article.
Doctors warn that the possibility of co-infection between monkeypox and Covid-19 may be common, especially among patients with a recent travel history. According to experts, the findings should encourage testing for the coronavirus, as well as thorough screening for other sexually transmitted infections following a diagnosis of monkeypox.
Source: CNN Brasil
