A case of simultaneous HIV, COVID-19, and monkeypox infection underscores diagnostic challenges
In a report discussed by the Italian press and described in a scientific study published in the Journal of Infection, a 36-year-old Italian resident became ill after returning from Spain. The individual’s illness trajectory included a cluster of infections detected in quick succession, raising important questions about how overlapping viral illnesses can present and complicate diagnosis. The report cites findings relayed by il Messaggero and references the study as a source of medical insight .
Clinical symptoms began roughly nine days after returning from travel. The patient experienced fever, sore throat, fatigue, headaches, and inflammatory changes in the groin area. It was also noted that during the trip the patient had unprotected sexual encounters with partners of the same sex. The timing of these events is relevant to understanding potential exposure vectors, immune response, and the likelihood of multiple concurrent infections presenting with overlapping symptomatology.
Three days after the onset of these symptoms, a positive test confirmed a COVID-19 infection. Soon afterward the patient developed a rash on the left arm, followed by the appearance of ulcers spreading across the body. This progression prompted a visit to the emergency department of a hospital in Catania, Sicily, where further investigations were carried out to clarify the patient’s infectious status.
Laboratory testing yielded positive results for both monkeypox and HIV. It is noted that the patient had tested negative for HIV within the previous year, suggesting a recent seroconversion. This detail emphasizes the need for clinicians to consider recent exposure histories and the possibility of rapid changes in infection status when evaluating patients with multisystem symptoms.
The patient was discharged about a week after recovering from both the coronavirus and the monkeypox infection. It is also reported that the individual has a history of bipolar disorder and manages this condition with ongoing medication, a factor that can influence overall clinical management and the perception of symptoms during infectious illness.
The authors of the study emphasize that the observed overlap between monkeypox and COVID-19 symptoms can complicate clinical assessments. They stress the importance of thorough patient history taking and careful inquiry into sexual practices when diagnosing potential co-infections. Such information can help clinicians distinguish between illnesses with similar presentations and ensure timely, appropriate treatment for each condition .
Additionally, findings indicate that in at least some individuals with monkeypox, a positive test may persist beyond clinical remission, as one patient showed a positive result up to 20 days after symptoms had begun to subside. This observation raises considerations about contagiousness in the period following apparent recovery and highlights the need for ongoing monitoring and clear guidance to prevent transmission during convalescence.
Overall, the case underlines the dynamic landscape of infectious diseases where multiple pathogens may circulate simultaneously. It reinforces the value of proactive screening, broad differential diagnosis, and careful documentation of patient histories to guide effective public health responses and clinical care in settings across Italy, the broader European region, and beyond.