Monkeypox and chickenpox co-infection in a person living with Human Immunodeficiency Virus

• Published in: Journal of infection in developing countries Vol. 18; no. 7; pp. 1152 - 1156
• Main Authors: Mmerem, Juliet I, Johnson, Simon M, Iroezindu, Michael O
• Format: Journal Article
• Language: English
• Published: 29.07.2024
• ISSN: 1972-2680; 1972-2680
• DOI: 10.3855/jidc.18318

Introduction: The 2022 mpox global outbreak underscores the need for an improved understanding of mpox epidemiology, co-morbidities, and clinical management/outcome. We report a case of a 30-year-old Nigerian antiretroviral treatment-experienced person living with human immunodeficiency virus (PLHIV) who had PCR-confirmed mpox and chickenpox co-infection. Case presentation: The patient presented with a generalized itchy rash of three weeks and antecedent low-grade fever. He had no recent travel, animal exposure, or same-sex relationship. Examination revealed generalized pustular and nodular eruptions without peripheral lymphadenopathy. Results: CD4 count was 78 cells/mm3, wound swab microscopy revealed Gram-positive cocci in clusters and Gram-negative bacilli while culture yielded Pseudomonas aeruginosa. Despite supportive care and definitive antimicrobial therapy, his clinical condition deteriorated with sepsis-related multi-organ dysfunction and ultimately death. Conclusions: Mpox and chickenpox co-infection may occur, with potentially fatal complications in the setting of advanced HIV disease. Increased surveillance for co-viral infections in PLHIV with febrile exanthema and aggressive management to improve outcome are recommended.