PDF(Pubmed)
Abstract：
The case report discusses a 29-year-old male with advanced HIV who experienced one of the longest, confirmed cases of monkeypox (mpox) infection. Despite treatment with antivirals and supportive care, including intravenous tecovirimat and vaccinia immune globulin, the patient\'s condition worsened over a six-and-a-half-month period. He suffered from widespread ulcerative, necrotic lesions and multiple complications, including acute kidney injury, multi-drug resistant bacterial infections, and respiratory failure. Despite repeated treatments, including brincidofovir, the patient remained PCR-positive for monkeypox virus (MPXV) with low cycle threshold (Ct) values, indicating active infection. The case underscores the severity of mpox in immunocompromised individuals, particularly those with advanced HIV, and highlights the challenges in managing such cases. The patient\'s persistently low CD4 count and unsuppressed HIV viral load likely contributed to the inability to clear the virus. The report emphasizes the need for further research to optimize treatment strategies for MPXV infection, especially in people living with HIV.
摘要：
病例报告讨论了一名29岁的男性，患有晚期艾滋病毒，确诊的猴痘（水痘）感染病例。尽管有抗病毒药物和支持治疗，包括静脉注射tecovirimat和牛痘免疫球蛋白，病人的病情在六个月半的时间里恶化了。他患有广泛的溃疡性疾病，坏死性病变和多种并发症，包括急性肾损伤,多药耐药细菌感染，和呼吸衰竭。尽管反复治疗,包括Brincidofovir,患者对猴痘病毒（MPXV）的PCR保持阳性，具有低循环阈值（Ct）值，表明活跃的感染。该病例强调了免疫受损个体中水痘的严重程度，特别是那些患有晚期艾滋病毒的人，并强调了管理此类案件的挑战。患者的持续低CD4计数和未抑制的HIV病毒载量可能导致无法清除病毒。该报告强调需要进一步研究以优化MPXV感染的治疗策略，尤其是艾滋病毒感染者。
