Case Report The Brief Case: Monkeypox Disseminated Cutaneous Lesions in an AIDS Patient
by Lukman Cheragvandi, John Samuel Costanza, Neda Zarrin-Khameh*
Department of Pathology and Immunology, Baylor College of Medicine, One Baylor Plaza, Houston, Texas, USA.
*Corresponding author: Neda Zarrin-Khameh, Department of Pathology and Immunology, Baylor College of Medicine, One Baylor Plaza, Houston, Texas, USA. and Ben Taub Hospital, 1504 Taub Loop, Houston, TX, 77030, USA.
Received Date: 27 February 2024
Accepted Date: 04 March 2024
Published Date: 06 March 2024
Citation: Cheragvandi L, Costanza JS, Zarrin-Khameh N, (2024). The Brief Case: Monkeypox Disseminated Cutaneous Lesions in an AIDS Patient. Ann Case Report 9: 1684. https://doi.org/10.29011/2574-7754.101684
bstract
A 43-year-old African-American man with HIV/AIDS who received irregular HARRT treatment was diagnosed with disseminated monkeypox. When the patient was presented to our hospital after three months of his diagnosis, monkeypox had caused gigantic verrucous skin lesions throughout the body as the HIV infection was not controlled. The patient was admitted for treatment and was discharged after 4 months. His large dermal lesions are almost healed now after 8 months of treatment.
Keywords: Monkeypox; AIDS; Skin lesions; Bacterial Infections; HAART Therapy
Case Presentation
A 43-year-old African-American man with HIV/AIDS who received irregular HARRT treatment was diagnosed with disseminated monkeypox three months before his presentation to our hospital. He received intermittent therapy and was presented with generalized fatigue, diffuse lymphadenopathy, and worsening of the extensive painful gigantic verrucous skin lesions (Figure 1). At the time of presentation to our hospital, he had a low-grade fever, and mild altered mental status and his CD4 count was 135 cells/uL (reference range: 431 – 1623 cells/uL). His cutaneous exanthema which started about 15 days prior to this presentation had evolved into disseminated lesions with large dark-crusted top up to 6 cm, some with an erythematous base and secondary bacterial infections (Figure 2). CT of chest showed multiple indeterminate solid pulmonary nodules. Brain CT showed juxtcortical white matter hypodensities, which were considered nonspecific as they may be related to sequela from prior opportunistic infection and/ or PMI.
Figure 1: An example of extensive involvement of the patient’s skin with large and thick verrucous lesions (elbow).