Atypical monkeypox presentation in a previously vaccinated MSM HIV-positive adult.

The outbreak of monkeypox virus (MPXV) in non-endemic countries is an international public health emergency, and the diversity in manifestations poses challenges for early diagnosis and isolation. We describe an atypical case of monkeypox (MPX) in a 46-year-old homosexual male living with HIV. He re...

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Published in:Infection Vol. 51; no. 3; pp. 783 - 787
Main Authors: Crosato, Verena, Degli Antoni, Melania, Izzo, Ilaria, Cerini, Carlo, Pennati, Francesca, Gulletta, Maurizio, Odolini, Silvia, Tomasoni, Lina Rachele, Matteelli, Alberto, Castelli, Francesco
Format: case study pictorial Journal Article
Published: Springer Nature Jun2023
Online Access:View this record in EBSCOhost
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      dt: Jun2023
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s15010-022-01967-9
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        atl: Atypical monkeypox presentation in a previously vaccinated MSM HIV-positive adult.
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        au:
          Crosato, Verena
          Degli Antoni, Melania
          Izzo, Ilaria
          Cerini, Carlo
          Pennati, Francesca
          Gulletta, Maurizio
          Odolini, Silvia
          Tomasoni, Lina Rachele
          Matteelli, Alberto
          Castelli, Francesco
        affil: Unit of Infectious and Tropical Diseases, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
      sug:
        subj:
          Monkeypox Diagnosis
          Poxvirus Infections Prevention and Control
          Men Who Have Sex With Men
          HIV-Positive Persons
          HIV Infections Drug Therapy
          Disease Outbreaks Prevention and Control
          Public Health
          Skin Ulcer
          Vaccination Coverage
          Sexual and Gender Minorities
          Middle Age
          Male
          Early Diagnosis
          Social Isolation
          Gay Men
          Fever Symptoms
          Biopsy
          Pyoderma Gangrenosum
          Superinfection
          Patient Discharge
          Skin Manifestations
          Vaccination Status
          Adult
          Middle Aged: 45-64 years
          Adult: 19-44 years
          Male
      ab: The outbreak of monkeypox virus (MPXV) in non-endemic countries is an international public health emergency, and the diversity in manifestations poses challenges for early diagnosis and isolation. We describe an atypical case of monkeypox (MPX) in a 46-year-old homosexual male living with HIV. He reported 1-day duration fever, a lesion on his chin that, over a period of 18 days, had gradually enlarged and ulcerated. Biopsy examination performed at an external centre revealed pyoderma gangrenosum, unconfirmed at a subsequent biopsy. When he reported to our hospital outpatients' clinic the chin lesion had a diameter of 5 × 5 cm, necrotic margins and ulcerated base and signs of superinfection. He was admitted for further investigations. Three swabs collected from pharynx, skin and chin lesion resulted positive for MPXV. He had a favourable clinical course and was discharged soon after. Pending the achievement of optimal vaccination coverage in at-risk groups, early identification and isolation of infectious patients represent the cornerstones of the containment strategy. Atypical cases of MPX manifestations are not uncommon, particularly in patients with HIV infection. A high level of suspicion should be maintained to identify infectious cases at an early stage and avoid further spread of the infection.
      pubtype: Academic Journal
      doctype:
        case study
        pictorial
        Journal Article
      ougenre: Article
    language: English
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