Ivanov Daniel Toshkov, Yancheva Nina Stoyanova, Valkov Trifon Kostadinov
Specialized Hospital for Active Treatment of Infectious and Parasitic Diseases "Prof. Ivan Kirov," Sofia, Bulgaria.
Department of Infectious Disease, Parasitology and Tropical Medicine, Medical University, Sofia, Bulgaria.
SAGE Open Med Case Rep. 2023 Oct 10;11:2050313X231204193. doi: 10.1177/2050313X231204193. eCollection 2023.
Monkeypox is an emerging zoonosis that has been declared a public health threat due to its spread outside of endemic areas. We present two cases of monkeypox: one involving a 39-year-old male patient living with HIV on antiretroviral therapy with detectable viraemia and a low CD4 count, and another involving a 44-year-old male, negative for HIV, who visited our Diagnostic and Consultative Unit with a new-onset skin rash. Both individuals identify as men who have sex with men and had travelled abroad before the disease onset. One patient was hospitalised, while the other was treated as an outpatient with follow-up care. Both cases were managed conservatively due to the unavailability of tecovirimat in Bulgaria. We emphasise the importance of recognising and diagnosing monkeypox and the significance of HIV screening, as monkeypox could be considered an AIDS-defining condition in people living with HIV. Maintaining a high level of suspicion for new cases is essential, as instances of monkeypox continue to be reported in non-endemic countries.
猴痘是一种新出现的人畜共患病，由于其在流行地区以外传播，已被宣布为公共卫生威胁。我们报告两例猴痘病例：一例涉及一名39岁男性患者，他感染艾滋病毒，正在接受抗逆转录病毒治疗，病毒血症可检测到且CD4细胞计数低；另一例涉及一名44岁男性，艾滋病毒检测呈阴性，因新发皮疹前来我们的诊断和咨询科室就诊。两名患者均为男男性行为者，在疾病发作前都曾出国旅行。一名患者住院治疗，另一名患者作为门诊患者接受治疗并进行随访。由于保加利亚没有tecovirimat，两例病例均采取保守治疗。我们强调认识和诊断猴痘的重要性以及艾滋病毒筛查的意义，因为猴痘可被视为艾滋病毒感染者的一种艾滋病界定疾病。对新病例保持高度怀疑至关重要，因为非流行国家仍不断有猴痘病例报告。
