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Progressively confluent monkeypox lesions with necrosis.
Kolton Smith1, Kelly Tyson1, Raeesa Hossain1
1Dept. of Internal Medicine, Lenox Hill Hospital, New York, NY, USA.
Oxford Medical Case Reports
|January 25, 2023
Summary
Monkeypox can cause severe illness in individuals with acquired immunodeficiency syndrome (AIDS). Intravenous tecovirimat may be necessary for effective treatment in these high-risk patients.
Area of Science:
- Infectious Diseases
- Virology
- Public Health
Background:
- Human monkeypox (mpox) emerged as a global health concern in 2022.
- Acquired immunodeficiency syndrome (AIDS) is a risk factor for severe infectious disease outcomes.
Observation:
- A 38-year-old male with AIDS presented with painful anal lesions confirmed as mpox.
- Outpatient oral tecovirimat treatment was ineffective due to lesion progression.
Findings:
- The patient's AIDS may have impaired oral tecovirimat absorption due to gut microbiome disruption and inability to meet fat intake requirements.
- Severe mpox cases in immunocompromised individuals may necessitate alternative treatment strategies.
Implications:
- Identifying patients at risk for severe mpox is crucial for optimizing treatment.
- Intravenous tecovirimat administration should be considered for patients with AIDS and mpox, bypassing oral absorption challenges.
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