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A 36-year-old returns ill after a short trip to Spain (icon image)
Photo: Alexandr Spatari/Getty Images
A 36-year-old man from Italy tested positive for three dangerous viral diseases at the same time: monkeypox, the corona virus and HIV.
It is the world's first known case of a co-infection of Sars-CoV-2 and the currently rampant monkeypox, reports researchers from the University of Catania in a case report.
The Italian therefore spent his five-day vacation in Spain and traveled back to Sicily on July 20.
Nine days later, he developed a fever, followed by a sore throat, headache, fatigue, and swollen lymph nodes.
Four days later, on July 2nd, his corona test was positive.
At the same time, he developed a rash on his left arm.
The following day, painful small blisters surrounded by a red halo appeared on the upper body, legs, face and buttocks.
The blisters continued to spread and developed into pustules.
On July 5, the man finally went to the emergency room of the university hospital in Catania.
When he was admitted, the doctors noted that the man had been double vaccinated against Sars-CoV-2 and had been infected in January of this year.
An HIV test in September 2021 was negative.
The patient also stated that he had had unprotected sex with men during his vacation in Spain.
He still complained of fever, difficulty swallowing, fatigue and headaches.
According to the doctors, his whole body, including the right palm and the anal region, was covered with red pustules in various stages.
The liver and spleen as well as the lymph nodes in the right groin were swollen.
Doctors tested him for Sars-CoV-2, monkeypox and several common sexually transmitted diseases.
A day later, the man received the test results that were positive for HIV, Sars-CoV-2 and Corona.
Based on his CD4 cell count, the doctors suspect that he must have recently been infected with the HI virus.
They first treated him with the corona drug Sotrovimab.
On the third day after his hospital admission, the monkeypox pustules began to crust, and by the fifth day the remaining symptoms had improved.
On the sixth day, the patient was released into home isolation as his tests were still positive.
When the man was retested for monkeypox at the clinic eight days later, his test was still positive.
The pustules, on the other hand, had largely healed, some had left small scars.
Doctors began antiretroviral treatment for HIV.
According to the doctors, the case shows how corona and monkeypox symptoms are partly similar.
Since both viruses are currently circulating worldwide, physicians should keep a possible co-infection in mind when making a diagnosis, especially if the patients have previously been in monkeypox outbreak regions.
If monkeypox is confirmed, patients should be tested for sexually transmitted diseases if possible.
Monkeypox numbers are falling
Globally, the number of newly reported monkeypox cases has decreased.
According to the World Health Organization (WHO), in the week from August 15 to 21 it was 21 percent less than in the previous week.
In the four weeks before, the numbers had risen.
"This decrease could reflect the first signs of a declining number of cases in the European region, which still have to be confirmed," said the WHO in Geneva on Thursday.
The Europe region includes 53 countries from the EU to Turkey, Turkmenistan, Russia and Israel.
In the North and South America region, on the other hand, the numbers continued to rise.
Globally, 5,907 cases were reported in the week, compared to 7,477 the week before.
In total, around 41,600 infections and twelve deaths from 96 countries have been reported to the WHO since the beginning of the year.
Germany is among the four countries with the highest numbers.
The Robert Koch Institute in Berlin reported 3,387 cases in Germany on Thursday.
kry/dpa
