An Italian man is the first in the world to test positive for COVID-19, monkeypox and HIV on the same day.
The unidentified 36-year-old first developed a fever, sore throat and headache nine days after returning from a trip to Spain where he had unprotected sex with other men, according to a case study in the Journal of Infection.
He first tested positive for COVID-19 on July 2 — and developed a rash and “small, painful” blisters around his body, legs, face and buttocks within hours, the study said.
He went to an emergency room and on the second day there again tested positive for COVID-19 – as well as monkey pox.
That same day, July 6, he also learned he had HIV, despite being negative when he last tested, in September, the study said.
“As this is the only reported case of co-infection with monkeypox virus, SARS-CoV-2 and HIV, there is still not enough evidence that this combination can worsen. [a] condition of the patient,” they wrote.
The researchers said the “case highlights that sexual intercourse could be the main mode of transmission” of monkeypox.
“So, complete [sexually transmitted infection] screening is recommended after a monkeypox diagnosis.
“Our patient even tested positive for HIV-1 and given his preserved CD4 count, we could assume the infection was relatively recent,” they noted about the patient, who also previously had syphilis.
While this is the first known case of its kind, more are likely to follow given the rapid spread of monkeypox, with more than 45,000 cases reported in 98 countries.
“Most cases were recorded in gay or bisexual men who frequently suffered from other STIs, they noted.
“As these pathogens continue to spread, individuals can become infected with monkeypox virus, SARS-CoV-2 and STIs at the same time, making it difficult for doctors to make the correct diagnosis,” they said, noting how many share similar symptoms.
“Healthcare systems should be aware of this possibility and promote appropriate diagnostic testing in high-risk individuals, which are essential for containment because there is no widely available treatment,” they wrote.