Table 1 Clinical and molecular characteristics of severely necrotic mpox in HIV-infected patients
Age / gender | Smallpox vaccination history | CD4+ count (cells/mm3) / HIV RNA (copies/mL) / HAART | Other comorbidities | Coinfections at time of mpox diagnosis | Molecular diagnosis, PCR (ct value) | Skin lesions (number) | CNS | Lung | Eye | Lymphadenopathy | Other organs | Complications | Mpox treatment | Outcome | |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Case 1 | 30/ Cis-gender man | No | 121 (5%) / 312,077 / Untreated | No | HSV-1 | Skin: positive (22) Throat: positive (26) Serum positive (23) Plasma: positive (21) Urine: positive (24) | > 200 (all body segments) | No | Probable (nodules on CT) | No | Yes (cervical, axillary, mediastinal) | Multiple organ failure | Preseptal cellulitis Tracheal stricture Orchitis Phimosis | Vaccinated donor plasma | Death |
Case 2 | 44/ Cis-gender man | No | 106 (6%) / 726,454 / Untreated | Type 2 Diabetes | HSV-2 | Skin: positive (NA) Throat: positive (24) Serum positive (29) Plasma: positive (29) Urine: positive (28) Esophagus: positive (24) Lung: positive (23) CSF: positive (35) | 100–200 (all body segments) | Yes (MPXV PCR + on CSF) | Yes (nodules on CT, MPXV PCR + on biopsy) | No | No | Multiple organ failure | Perianal abscess/fistula Esophagitis | No | Death |
Case 3 | 37/ Cis-gender man | No | 25 (3%) / 31,385 / Recent start | No | HSV-2 Oral candidiasis | Skin: positive (NA) Throat: positive (25) Serum positive (25) Plasma: positive (24) Urine: positive (35) | < 50 (all body segments) | No | No | No | Yes (axillary, inguinal) | Multiple organ failure | Cellulitis / compartmental syndrome Proctitis Tracheal stricture | No | Death |
Case 4 | 25/ Cis-gender man | No | 68 (7%) / 367 / 6 month after initiation | No | No | Skin: positive (NA) | 50–100 (all body segments) | No | Possible (micro-nodules on CT) | No | No | Hepatomegaly | Impetiginization Cellulitis | No | Alive |
Case 5 | 58/ Cis-gender man | No | 177 (8%) / Undetectable/ Irregular adherence | No | HSV-2 HPV | Skin: positive (NA) | 50–100 (all body segments) | No | No | No | No | No | Perianal abscess | No | Alive |