A 36-year-old Italian man has simultaneously tested positive to COVID, HIV and monkeypox making this a world first event.

The triple co-infection was recorded after the man holidayed for a week in Spain. Nine days following his trip, he developed a fever, rash and as subsequent testing went on it was evident he was in for a wild ride.

The man spent five days in Spain from June 16-20 and enjoyed his holiday to the fullest, seemingly engaging in unprotected sex with other men during that time.

Upon returning to Italy, he developed a 39C fever, sore throat, fatigue and headache. The party-goer tested positive to COVID on July 2, and the same afternoon began to develop a rash on his left arm.

On July 3 small, painful blisters appeared on his torso, lower limbs, face and other parts of the body.

“On physical examination his body was dotted, including the palm of the right hand and the perianal region, with skin lesions in various stages of progression,” the report said.

The blisters spread all over the body until July 5, evolving into umbilicated pustules, before he was moved to the emergency department and then to the Infectious Diseases unit at a hospital in Catania.

This was when he tested positive to monkeypox.

“Complete STI screening is recommended after a diagnosis of monkeypox,” the report said.

The STI screening found he also tested positive for HIV, given this diagnosis was not the patient’s first brush with an STI. Previous reports noted: “On admission, the patient reported being treated for syphilis in 2019.”

“This case highlights how monkeypox and COVID symptoms may overlap, and corroborates how in case of co-infection, anamnestic collection and sexual habits are crucial to perform the correct diagnosis,” the report said.

“As this is the only reported case of monkeypox virus, SARS-CoV-2 and HIV co-infection, there is still not enough evidence supporting that this combination may aggravate patient’s condition.”

The patient was treated and discharged to home isolation on July 11 as his symptoms resolved. He returned for a checkup on July 19, still testing positive with monkeypox but with the lesions having slowly improved, he is now to begin HIV treatment.

Image: Getty Images

This article first appeared on OverSixty.