Abstract
•Patients display distinct skin pathologies while sharing similar clinical features•HIV patient co-infected with monkeypox had severe cutaneous abnormalities•HCV patient co-infected with monkeypox present with mild skin changes•Type of prior viral infection determines the severity of monkeypox infection
Monkeypox (MPox) is a zoonotic virus in the genus Orthopoxvirus. It is transmitted from animal to human, and between humans. The clinical presentations vary, starting with a prodrome phase to different skin findings and systemic complications.
We present two distinctive cases of MPox co-infected with other viruses (Hepatitis C Virus, HCV; and Human Immunodeficiency Virus, HIV). Surprisingly, the MPox patient with a history of HCV developed different skin pathological characteristics (less severe inflammatory changes than the classic HCV or MPox patient alone). In contrast, HIV-infected patients presented with MPox had severe inflammatory cutaneous changes, and distortion of the skin architecture.
Our findings strongly suggest that the MPox infections likely occur in the presence of one or more previous other viral infections, and the prior infection with specific microbes determines the severity of MPox infection.
