Preprint Case Report Version 1 Preserved in Portico This version is not peer-reviewed

Prolonged, Atypical and Fulminant Mpox in an HIV/HBV Coinfected Patient: A Case Report

Version 1 : Received: 26 February 2023 / Approved: 28 February 2023 / Online: 28 February 2023 (04:51:43 CET)

A peer-reviewed article of this Preprint also exists.

Perez-Hernandez, F. de J.; Alvarez-Sanchez, V.A.; Torres-Erazo, D.; Ceballos-Perez, M.; Franco-Gonzalez, C.D. Prolonged, Atypical, and Fulminant Mpox in a HIV/HBV-Coinfected Patient: A Case Report. Cureus 2024, doi:10.7759/cureus.52043. Perez-Hernandez, F. de J.; Alvarez-Sanchez, V.A.; Torres-Erazo, D.; Ceballos-Perez, M.; Franco-Gonzalez, C.D. Prolonged, Atypical, and Fulminant Mpox in a HIV/HBV-Coinfected Patient: A Case Report. Cureus 2024, doi:10.7759/cureus.52043.

Abstract

Mpox (monkeypox) is a zoonotic disease that has been endemic in African countries for decades, with a recent outbreak in several countries around the world. A 39-year-old male with HIV-HBV coinfection and poor adherence to antiretroviral treatment, who was severely immunocompromised and had a concurrent diagnosis of Mpox infection, presented to our hospital with disseminated dermatosis (over 350 lesions), perianal ulcers, odynophagia, oral intolerance, diarrhea, and soft-tissue bacterial superinfection of the lower extremities. Laboratory results were consistent with HBV infection, with an absolute CD4 cell count of 40 cells/uL and a positive PCR result for Mpox. An abdominopelvic CT scan showed evidence of severe proctitis and perineal soft-tissue infection. After 65 days of Mpox PCR, new lesions in the vesicular stage continued to appear, eventually developing hemodynamic instability and sepsis, resulting in a fatal outcome. Our case highlights the importance of intentionally looking for risk factors such as HIV/HBV coinfection and evaluating immune status (CD4 cell count) in patients with severe Mpox infection because it could be related to higher mortality.

Keywords

atypical; coinfection; Hepatitis B; human immunodeficiency virus; monkeypox

Subject

Medicine and Pharmacology, Epidemiology and Infectious Diseases

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