A 36-year-old man in Italy all tested positive for COVID-19, monkey pox and HIV at the same time in July after having unprotected sex with men during a trip to Spain. According to a new case report, the man is the first recorded patient to have had these three viruses at the same time.
The patient spent five days in Spain in June. Nine days after returning home from his trip, he developed a fever, sore throat, fatigue, headache and inflammation in his groin area. Shortly after, he tested positive for SARS-CoV-2 and within a day had a rash on his left arm. The next day, small, painful blisters appeared on his trunk, lower extremities, face and buttocks.
Due to the spread of the blisters that started to develop into pustules, he decided to go to the emergency room of the hospital in Catania and was transferred to the Infectious Diseases Department.
After admission, the patient reported that he had had unprotected sex with men during his stay in Spain. He was tested for monkey pox and tested positive for the West African variant of the virus, which has been found to be responsible for the outbreak in Spain. Even after 20 days, the monkeypox tests remained positive, with the doctors stressing that this could mean the patient may remain infectious for several days after clinical remission.
The Italian had been treated for syphilis in 2019 and suffered from bipolar disorder, according to the case report. He had been vaccinated with two doses of the Pfizer COVID-19 vaccine in 2021 and had contracted the virus in January 2022.
According to the researchers, the man had a high HIV viral load (234,000 copies per milliliter of blood) when he was admitted, which may mean that he was recently infected.
The 36-year-old was released from hospital after about a week and recovered from both monkey pox and coronavirus. The researchers from the University of Catania said the case shows how monkeypox and COVID-19 symptoms “may overlap” and confirm that “co-infection, anamnestic collection and sexual habits” are important for diagnosis.
