Horror diagnosis to the power of three: After a short vacation in Spain, an Italian man tested positive for corona, monkeypox and HIV at the same time. It is the world’s first known triple infection.
Nobody wants to have this souvenir with them in their luggage. An Italian man contracted Covid-19, HIV and monkeypox simultaneously on a short vacation in Spain.
According to a case report published in the Journal of Infection, the 36-year-old tested positive for Covid-19, monkeypox and HIV in less than a week. This is the first diagnosed case of co-infection with associated diseases.
Nine days after his return, the patient is said to have developed the following symptoms:
A Covid-19 infection was found four days later, and the man developed further symptoms on the same day:
After the rash rapidly worsened – the man developed pustules and scars in appropriate areas – he went to the emergency department of a hospital in Catania, where he was transferred to the highly contagious diseases ward. After a series of tests, he also received positive results for monkeypox and HIV in addition to Covid-19. The person concerned fell ill with Covid-19 in January of this year – even though he had been vaccinated twice.
“The case shows how monkeypox and Covid 19 symptoms can overlap,” the scientists warn in their report.
The corona virus is mainly passed on by virus-containing particles, which are produced, among other things, when breathing, coughing and speaking. Since close contact is not necessary for infection – unlike monkeypox – the virus can spread quickly. An infection with the currently circulating omicron variant is shown by the following symptoms, among others:
The symptoms mentioned are similar to the side effects of a monkeypox infection. Monkeypox viruses are mainly transmitted from person to person through close physical contact, including via blister contents and scab. A monkeypox infection is manifested by the following symptoms:
The symptoms last about two to four weeks. Skin damage occurs – in addition to the regions affected by the rash – sometimes also in the mouth and throat mucosa as well as in the genital and anal areas.
The fact that the young man was also infected with HIV indicates that he was infected during sexual intercourse. As the researchers state in their report, the man had unprotected sex with other men during his five-day stay. The HIV test showed a high viral load of 234,000 virus copies per milliliter of blood plasma. According to the researchers, this shows that the man was only recently infected.
In 2019, the patient was said to have already contracted syphilis – an easily transmitted bacterial sexually transmitted disease that affects the entire body – but an HIV test in 2021 had been unremarkable. People who carry the syphilis pathogen can generally contract HIV more easily. So, had past syphilis infection increased the likelihood of present HIV infection?
As the scientists state in the study, the multiple infection could also have meant that the monkeypox was transmissible for a longer period of time – a tracheal swab was still positive 20 days after the patient had been in domestic isolation in the meantime.
In order to be able to make well-founded statements about the transmissibility of the viruses mentioned in the case of an existing infection, further investigations would have to be carried out, the researchers explain. Nevertheless, they emphasize: “In view of the current Sars-Cov-2 pandemic and the daily increasing number of monkeypox cases, health systems must be aware of the possible consequences for patients”.
As the scientists write, unprotected sexual intercourse is the primary mode of transmission of monkeypox. If a monkeypox infection is suspected, physicians should therefore carry out a “complete STI screening”.
The abbreviation STI stands for sexually transmitted infections. In addition to HIV, there are 30 known different STIs worldwide that can be transmitted during sex. The most well-known include:
People who have recently been in one of the areas where monkeypox broke out, who have had unprotected sex or who have been in close contact with many people can be described as patients at risk.
In the meantime, the patient is said to have survived the infections with Covid-19 and monkeypox, but a small scar is still visible. As the scientists emphasize, the health system must be made aware of similar co-infections against the background of the daily increase in the number of monkeypox and Covid-19 cases. There is still no cure for HIV, which makes it all the more important to avoid infection – possibly aggravated by previous infections.
