An Italian tested positive at the same time as Covid-19, HIV and monkeypox

An Italian tested positive at the same time as Covid-19

For the first time, a case of co-infection with monkeypox virus, Covid-19 and HIV has been documented: it is a 36-year-old Italian man, returning from a trip to Spain and hospitalized for about two weeks at Polyclinic “G. Rodolico - San Marco ”of Catania. This is what we learn from an article published in the Journal of Infection, which reports the clinical history of the unfortunate patient who, during last July, would have tested positive for all three viruses: discharged from hospital for some time, now he would be fine.

Similarities between viruses More than 16 thousand people in 74 countries around the world, starting from the beginning in 2022, have been affected by monkeypox, an infectious disease caused by the Monkeypox virus, a pathogen belonging to the same genus of human smallpox which is transmitted mainly through close contact with infectious material from skin lesions, seminal fluids and secretions of the nose and mouth of infected people. The wide spread of this disease (whose contagion is usually infrequent in humans) prompted the World Health Organization, on 23 July, to declare it an international public health emergency. As we recall and as reported by the Ministry of Health, monkeypox manifests itself with heterogeneous symptoms and is able to cause disease courses that vary from case to case: generally those affected have mild symptoms, such as fever, drowsiness, pain muscle and headaches, which precede the appearance of skin lesions throughout the body, especially in the extremities of the limbs, on the head and on the torso. Symptoms typically last two to three weeks and usually go away on their own.

Identifying a case of monkeypox is not always immediate, as the clinical manifestations of this disease, especially the initial ones, have many similarities with those of other infections, including Covid-19, which, at a distance of two and a half years after its appearance, it continues to represent one of the most widespread diseases and a leading cause of mortality globally. In addition, in addition to having some symptoms in common (including the appearance of skin manifestations, albeit rarer in the case of Covid-19), the disease caused by Sars-cov-2 also shares the mode of transmission with monkeypox. saliva droplets, which causes it to spread widely within the population. For this reason, the study reads, these pathogens continue to spread widely globally, and it can happen that not only some people are infected with both viruses at the same time, but in case of infection through unprotected sexual intercourse, they also contract diseases. sexually transmitted.

The Italian case This is what happened to the case presented in the study. The patient, a 36-year-old Italian man, spent five days in Spain, from June 16 to 20, developing, just over a week after his return, fever, sore throat, fatigue, headache and swelling of the lymph nodes: on 2 July tested positive for Sars-cov-2. However, after the onset of flu-like symptoms, small painful blisters began to appear all over the patient's body (especially on the lower limbs, torso and face), which then became pustules; at this point, the patient went to the emergency room of the Catania hospital, where he was admitted to the infectious disease ward. Following further analysis, the man tested positive for Sars-cov-2 (lineage variant BA.5.1, i.e. omicron 5) and for monkeypox virus, in particular the West African clade, the variant responsible. of the epidemic in Spain and, as reported by the Higher Institute of Health (Iss), associated with a less serious disease. Since the patient declared that he had unprotected sexual intercourse during his stay in Spain, he was subjected to other serological tests and also tested positive for HIV: according to the authors of the article, it would be an infection recent.

Fortunately, the course of the diseases was quite rapid: on the fifth day of hospitalization almost all the symptoms reported by the patient had disappeared and the blood values ​​returned to normal. After being discharged in home isolation, after a week the scabs of the skin lesions healed, while, in the meantime, the patient began antiviral treatment for HIV. According to the authors, the study highlights how the symptoms of monkeypox and Covid-19 can overlap and recalls the importance of carrying out thorough investigations to make a correct diagnosis. In addition, the article reads, this case would suggest that the predominant mode of transmission for monkeypox could be sexual.