Mpox in a patient with AIDS: clinical management with tecovirimat and surgical correction of unaesthetic scars
Year: 2025
Type: article
Abstract: Mpox in a patient with AIDS: clinical management with tecovirimat and surgical correction of unaesthetic scarsDear Editor, A 33-year-old male patient, single, born and raised in Manaus, Amazonas, Brazil, sought medical care due to ulcerated lesions on the face, chest, upper limbs, gluteal region, and anorectal mucosa (Figs. 1 and 2).He also reported recurrent fever and anal pain.He had been treated with several medications, such as anti-inflammatory drugs, topical, and systemic antibiotics, for over a month, without response.He had no neurological or respiratory symptoms and denied comorbidities.Laboratory tests were requested, and the main results were: qPCR for Monkeypox ---detectable virus; Anti-HIV --reactive; VDRL ---1:256; cerebrospinal fluid analysis ---no findings suggestive of neurosyphilis; colonoscopy ---ulcerative proctitis (Fig. 1).The anatomopathological examination of the ulcerated skin lesion showed epidermal necrosis, ballooning of keratinocytes, Guarnieri inclusion bodies and a dermal inflammatory infiltrate consisting of histiocytes, lymphocytes and neutrophils (Fig. 3).The initial treatment included benzathine penicillin, a single dose of 2.4 million IU, with a subsequent adequate decrease in VDRL; and antiretrovirals (Dolutegravir, Lamivudine and Tenofovir), in addition to supportive measures.Given the worsening of the skin lesions, anal pain, and extension of the anorectal involvement, the patient was hospitalized in isolation, submitted to colostomy and, seven days after admission, started treatment with tecovirimat, 600 mg every 12 hours, for 14 days.Approximately 20 days after starting therapy with tecovirimat, associated with systemic antibiotic therapy for secondary infection, healing of the skin lesions was observed (Fig. 2), without adverse events.The regression of the skin ulcers evolved with hypertrophic scars, mainly in the glabella and labiomental region.
Language: English
Subfield: Virology
Field: Immunology and Microbiology
Domain: Life Sciences
Open Access status: gold
Estimated APC paid: $1,700
OpenAlex ID: W4409261697