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Monkeypox infection presenting as genital rash, Australia, May 2022 - Eurosurveillance

Mary Wilson

Well-known member
Received: 24 May 2022; Accepted: 02 Jun 2022

https://doi.org/10.2807/1560-7917.ES.2022.27.22.2200411

Hammerschlag Yael, MacLeod Gina, Papadakis Georgina, Adan Sanchez Asiel, Druce Julian, Taiaroa George, Savic Ivana, Mumford Jamie, Roberts Jason, Caly Leon, Friedman Deborah, Williamson Deborah A, Cheng Allen C, McMahon James H

Abstract

Rapid diagnosis and whole genome sequencing confirmed a case of monkeypox in an HIV-positive individual receiving antiretroviral therapy. The patient had a normal CD4+ T-cell count and suppressed HIV viral load and presented with a genital rash in Melbourne, Australia after return from Europe in May 2022. He subsequently developed systemic illness and disseminated rash and 11 days after symptom onset, he was hospitalised to manage painful bacterial cellulitis of the genital area.

Case description

An HIV-positive man in his 30s receiving co-formulated Abacavir, Lamivudine and Dolutegravir and with a CD4 + T-cell count above 700 cells/mm[SUP]3[/SUP] (normal range 410–1,545 cells/mm[SUP]3[/SUP]) and HIV viral load < 100 copies/mL, visited a primary care doctor after his return from Europe to Melbourne, Australia. He reported onset of a genital rash 8 days earlier. The rash had started 5 days after he reported unprotected insertive anal intercourse with four casual male partners in Europe. The initial symptoms were painless white pustules on the penis that became painful and pruritic. He reported that he developed a fever and malaise 3 days after the first appearance of the penile rash and over the subsequent 5 days, the rash disseminated to his trunk, then more sparingly to the face and limbs while the genital lesions crusted over. ...


https://www.eurosurveillance.org/content/10.2807/1560-7917.ES.2022.27.22.2200411#html_fulltext
 
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