An Italian man had an exceptionally unlucky holiday, returning home to find he had contracted Covid-19, monkeypox, and HIV all at once.
There are no known cases of any one person being infected with all three of these diseases, let alone at the same time.
The New Zealand Herald reported on August 25, that a recent paper published by a team of Italian academics from the University of Catania in the Journal of Infection, focused on a 36-year-old man from Italy who had spent five days in Spain from 16-20 June this year.
Spain was one of the first countries in the world to report a monkeypox outbreak.
The man admitted to researchers that while on vacation in Spain, he had unprotected sex with multiple male partners and that he developed a fever, sore throat, fatigue, headache, and swollen lymph nodes in the groin nine days later.
After testing positive for coronavirus on June 2, he began developing a rash on his left arm.
The following day, he developed small, painful blisters that appeared on his torso, lower limbs, face, and glutes.
“After the blisters turned into pustules, the man went to the emergency department at a hospital in Catania,” the report read.
Testing negative for HIV in September last year, the man had also been fully vaccinated against Covid-19 in the same year but contracted Covid-19 in January 2022.
"This case highlights how monkeypox and Covid-19 symptoms may overlap; hence, clinicians should be aware of the possibility of SARS-CoV-2 and monkeypox virus co-infection,” said the paper.
As he had likely acquired monkeypox through sexual intercourse, an HIV test was then performed, which also came back positive. The results indicated that he had probably contracted that virus recently as well, most likely in Spain.
Although HIV is a sexually transmitted infection, monkeypox is not and is usually passed through contact with the infected rash, scabs, or fluids. It can also be transmitted through non-sexual contact and even from materials used by someone with monkeypox.
However, researchers said that intercourse “is a successful way for this contact to occur and in the recent outbreak has accounted for most, although not all, cases.”
"Our case emphasises that sexual intercourse could be the predominant way of transmission."
Therefore, complete STI screening is recommended after a diagnosis of monkeypox. "
The man was discharged from the hospital on July 11 and was isolated at home. Most cases are mild, and people make a full recovery.
HIV can be both undetectable and non-transmissible.
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