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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
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Orientador(es)
Resumo(s)
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.
Descrição
Palavras-chave
mpox AIDS HIV progressive enteropathy fatal cidofovir tecovirimat
Contexto Educativo
Citação
Caria J, Vara-Luiz F, Maia I, Joosten A, Val-Flores L, Pinheiro H, Póvoas D, Germano N, Maltez F. Fatal Case of Progressive Mpox in a Patient with AIDS—Viral Enteropathy and Malabsorption Demanding the Use of Full Parenteral ARV and Endovenous Cidofovir. Infectious Disease Reports. 2023; 15(2):171-179. https://doi.org/10.3390/idr15020018
Editora
MDPI