An Italian brought back bad memories from his holiday in Spain after testing positive for COVID-19, monkeypox and HIV on the same day last July.
The 36-year-old first had a fever, sore throat, and headache nine days after returning from a trip where he had sex with other men without a condom.
This case study appeared in the scientific journal Journal of infection.
The Italian first tested positive for COVID-19 on July 2. Soon after, the same day, he began having rashes and small, but painful pustules on his body, arms, and buttocks, the study reports.
He went to the emergency room where he tested positive for monkeypox. He then learned the same day that he had HIV, despite having tested negative in September 2021.
“As this is the only reported case of co-infection with the simian pox virus, SARS-CoV-2 and HIV, there is insufficient data to say that this combination can worsen the condition of a patient,” the researchers wrote.
They argue, however, that sexual intercourse may be the predominant mode of transmission for monkeypox.
Therefore, comprehensive screening for sexually transmitted infections is recommended after a diagnosis of “monkeypox”, say the researchers.
Although this is the first known case of this type of co-infection, others could follow due to the rapid spread of monkeypox, with more than 45,000 cases reported in 98 countries.
The majority of cases have been recorded in homosexual or bisexual men often suffering from other sexually transmitted infections.
Moreover, they observe that certain symptoms of these three viruses are similar and make their diagnosis more complex.
“Health systems need to be aware of this possibility, promoting appropriate diagnostic testing in high-risk subjects.”