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Fatal Case of Progressive Mpox in a Patient with AIDS—Viral Enteropathy and Malabsorption Demanding the Use of Full Parenteral ARV and Endovenous Cidofovir
We report a fatal case of disseminated mpox infection that progressed over more than three months in an HIV-infected patient with acquired immunodeficiency syndrome (AIDS). Mucocutaneous, pleuropulmonary, central nervous system, and gastrointestinal involvement was documented. This course of disease...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10037604/ https://www.ncbi.nlm.nih.gov/pubmed/36960970 http://dx.doi.org/10.3390/idr15020018 |
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author | Caria, João Vara-Luiz, Francisco Maia, Inês Joosten, Anneke Val-Flores, Luís Pinheiro, Hélder Póvoas, Diana Germano, Nuno Maltez, Fernando |
author_facet | Caria, João Vara-Luiz, Francisco Maia, Inês Joosten, Anneke Val-Flores, Luís Pinheiro, Hélder Póvoas, Diana Germano, Nuno Maltez, Fernando |
author_sort | Caria, João |
collection | PubMed |
description | We report a fatal case of disseminated mpox infection that progressed over more than three months in an HIV-infected patient with acquired immunodeficiency syndrome (AIDS). Mucocutaneous, pleuropulmonary, central nervous system, and gastrointestinal involvement was documented. This course of disease resembles progressive vaccinia, a formerly reported disease caused by uncontrolled replication of smallpox vaccination orthopoxviruses in immunosuppressed patients. Severe small bowel involvement jeopardized normal oral tecovirimat and antiretroviral therapy absorption. This problem prompted the use of full parenteral antiretrovirals and endovenous cidofovir. Although a remarkable decrease in HIV viral load occurred in six days, mpox infection continued to progress, and the patient died of septic shock. This case offers new clinical insights on the presentation of severe disease in AIDS patients. Moreover, this case alerts for the need for prompt therapy initiation in patients at risk of ominous clinical progression. |
format | Online Article Text |
id | pubmed-10037604 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-100376042023-03-25 Fatal Case of Progressive Mpox in a Patient with AIDS—Viral Enteropathy and Malabsorption Demanding the Use of Full Parenteral ARV and Endovenous Cidofovir Caria, João Vara-Luiz, Francisco Maia, Inês Joosten, Anneke Val-Flores, Luís Pinheiro, Hélder Póvoas, Diana Germano, Nuno Maltez, Fernando Infect Dis Rep Case Report We report a fatal case of disseminated mpox infection that progressed over more than three months in an HIV-infected patient with acquired immunodeficiency syndrome (AIDS). Mucocutaneous, pleuropulmonary, central nervous system, and gastrointestinal involvement was documented. This course of disease resembles progressive vaccinia, a formerly reported disease caused by uncontrolled replication of smallpox vaccination orthopoxviruses in immunosuppressed patients. Severe small bowel involvement jeopardized normal oral tecovirimat and antiretroviral therapy absorption. This problem prompted the use of full parenteral antiretrovirals and endovenous cidofovir. Although a remarkable decrease in HIV viral load occurred in six days, mpox infection continued to progress, and the patient died of septic shock. This case offers new clinical insights on the presentation of severe disease in AIDS patients. Moreover, this case alerts for the need for prompt therapy initiation in patients at risk of ominous clinical progression. MDPI 2023-03-16 /pmc/articles/PMC10037604/ /pubmed/36960970 http://dx.doi.org/10.3390/idr15020018 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Case Report Caria, João Vara-Luiz, Francisco Maia, Inês Joosten, Anneke Val-Flores, Luís Pinheiro, Hélder Póvoas, Diana Germano, Nuno Maltez, Fernando Fatal Case of Progressive Mpox in a Patient with AIDS—Viral Enteropathy and Malabsorption Demanding the Use of Full Parenteral ARV and Endovenous Cidofovir |
title | Fatal Case of Progressive Mpox in a Patient with AIDS—Viral Enteropathy and Malabsorption Demanding the Use of Full Parenteral ARV and Endovenous Cidofovir |
title_full | Fatal Case of Progressive Mpox in a Patient with AIDS—Viral Enteropathy and Malabsorption Demanding the Use of Full Parenteral ARV and Endovenous Cidofovir |
title_fullStr | Fatal Case of Progressive Mpox in a Patient with AIDS—Viral Enteropathy and Malabsorption Demanding the Use of Full Parenteral ARV and Endovenous Cidofovir |
title_full_unstemmed | Fatal Case of Progressive Mpox in a Patient with AIDS—Viral Enteropathy and Malabsorption Demanding the Use of Full Parenteral ARV and Endovenous Cidofovir |
title_short | Fatal Case of Progressive Mpox in a Patient with AIDS—Viral Enteropathy and Malabsorption Demanding the Use of Full Parenteral ARV and Endovenous Cidofovir |
title_sort | fatal case of progressive mpox in a patient with aids—viral enteropathy and malabsorption demanding the use of full parenteral arv and endovenous cidofovir |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10037604/ https://www.ncbi.nlm.nih.gov/pubmed/36960970 http://dx.doi.org/10.3390/idr15020018 |
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