{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T16:54:58Z","timestamp":1787849698959,"version":"build-2784847793"},"reference-count":15,"publisher":"Springer Science and Business Media LLC","issue":"3","license":[{"start":{"date-parts":[[2023,1,13]],"date-time":"2023-01-13T00:00:00Z","timestamp":1673568000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,1,13]],"date-time":"2023-01-13T00:00:00Z","timestamp":1673568000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100007343","name":"Universit\u00e0 degli Studi di Brescia","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100007343","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Infection"],"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>The outbreak of monkeypox virus (MPXV) in non-endemic countries is an international public health emergency, and the diversity in manifestations poses challenges for early diagnosis and isolation. We describe an atypical case of monkeypox (MPX) in a 46-year-old homosexual male living with HIV. He reported 1-day duration fever, a lesion on his chin that, over a period of 18\u00a0days, had gradually enlarged and ulcerated. Biopsy examination performed at an external centre revealed pyoderma gangrenosum, unconfirmed at a subsequent biopsy. When he reported to our hospital outpatients\u2019 clinic the chin lesion had a diameter of 5\u2009\u00d7\u20095\u00a0cm, necrotic margins and ulcerated base and signs of superinfection. He was admitted for further investigations. Three swabs collected from pharynx, skin and chin lesion resulted positive for MPXV. He had a favourable clinical course and was discharged soon after. Pending the achievement of optimal vaccination coverage in at-risk groups, early identification and isolation of infectious patients represent the cornerstones of the containment strategy. Atypical cases of MPX manifestations are not uncommon, particularly in patients with HIV infection. A high level of suspicion should be maintained to identify infectious cases at an early stage and avoid further spread of the infection.<\/jats:p>","DOI":"10.1007\/s15010-022-01967-9","type":"journal-article","created":{"date-parts":[[2023,1,13]],"date-time":"2023-01-13T12:05:03Z","timestamp":1673611503000},"page":"783-786","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Atypical monkeypox presentation in a previously vaccinated MSM HIV-positive adult"],"prefix":"10.1007","volume":"51","author":[{"given":"Verena","family":"Crosato","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melania","family":"Degli Antoni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilaria","family":"Izzo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlo","family":"Cerini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Pennati","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maurizio","family":"Gulletta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"Odolini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lina Rachele","family":"Tomasoni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Matteelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Castelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,1,13]]},"reference":[{"key":"1967_CR1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2022.10802","author":"J Guarner","year":"2022","unstructured":"Guarner J, Del Rio C, Malani PN. Monkeypox in 2022-What clinicians need to know. JAMA. 2022. https:\/\/doi.org\/10.1001\/jama.2022.10802. (Epub ahead of print).","journal-title":"JAMA"},{"key":"1967_CR2","doi-asserted-by":"publisher","first-page":"280","DOI":"10.1053\/j.spid.2004.09.001","volume":"15","author":"BL Ligon","year":"2004","unstructured":"Ligon BL. Monkeypox: a review of the history and emergence in the Western hemisphere. Semin Pediatr Infect Dis. 2004;15:280\u20137. https:\/\/doi.org\/10.1053\/j.spid.2004.09.001.","journal-title":"Semin Pediatr Infect Dis"},{"key":"1967_CR3","unstructured":"WHO Factsheets\/Monkeypox. https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/monkeypox."},{"key":"1967_CR4","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.26531","volume":"14","author":"J Kaler","year":"2022","unstructured":"Kaler J, Hussain A, Flores G, Kheiri S, Desrosiers D. Monkeypox: a comprehensive review of transmission, pathogenesis, and manifestation. Cureus. 2022;14: e26531. https:\/\/doi.org\/10.7759\/cureus.26531.","journal-title":"Cureus"},{"key":"1967_CR5","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0007791","volume":"13","author":"EM Beer","year":"2019","unstructured":"Beer EM, Rao VB. A systematic review of the epidemiology of human monkeypox outbreaks and implications for outbreak strategy. PLoS Negl Trop Dis. 2019;13: e0007791. https:\/\/doi.org\/10.1371\/journal.pntd.0007791.","journal-title":"PLoS Negl Trop Dis"},{"key":"1967_CR6","doi-asserted-by":"publisher","first-page":"1894","DOI":"10.3390\/v14091894","volume":"14","author":"G Tiecco","year":"2022","unstructured":"Tiecco G, Degli Antoni M, Storti S, Tomasoni LR, Castelli F, Quiros-Roldan E. Monkeypox, a literature review: What is new and where does this concerning virus come from? Viruses. 2022;14:1894. https:\/\/doi.org\/10.3390\/v14091894.","journal-title":"Viruses"},{"key":"1967_CR7","unstructured":"CDC Factsheet\/Monkeypox. https:\/\/www.cdc.gov\/poxvirus\/monkeypox\/index.html (accessed Jul. 31, 2022)."},{"key":"1967_CR8","doi-asserted-by":"publisher","DOI":"10.37201\/req\/059.2022","author":"MC Mart\u00edn-Delgado","year":"2022","unstructured":"Mart\u00edn-Delgado MC, Mart\u00edn S\u00e1nchez FJ, Mart\u00ednez-Sell\u00e9s M, Molero Garc\u00eda JM, Moreno Guill\u00e9n S, Rodr\u00edguez-Artalejo FJ, Ruiz-Galiana J, Cant\u00f3n R, De Lucas Ramos P, Garc\u00eda-Botella A, Garc\u00eda-Lled\u00f3 A, Hern\u00e1ndez-Sampelayo T, G\u00f3mez-Pav\u00f3n J, Gonz\u00e1lez Del Castillo J, Mu\u00f1oz P, Valerio M, Catal\u00e1n P, Burillo A, Cobo A, Alcam\u00ed A, Bouza E. Monkeypox in humans: a new outbreak. Rev Esp Quimioter. 2022. https:\/\/doi.org\/10.37201\/req\/059.2022. (Epub ahead of print).","journal-title":"Rev Esp Quimioter"},{"key":"1967_CR9","doi-asserted-by":"publisher","first-page":"2200421","DOI":"10.2807\/1560-7917.ES.2022.27.22.2200421","volume":"27","author":"A Antinori","year":"2022","unstructured":"Antinori A, Mazzotta V, Vita S, Carletti F, Tacconi D, Lapini LE, D\u2019Abramo A, Cicalini S, Lapa D, Pittalis S, Puro V, RivanoCapparuccia M, Giombini E, Gruber CEM, Garbuglia AR, Marani A, Vairo F, Girardi E, Vaia F, Nicastri E, INMI Monkeypox Group. Epidemiological, clinical and virological characteristics of four cases of monkeypox support transmission through sexual contact, Italy, May 2022. Euro Surveill. 2022;27:2200421. https:\/\/doi.org\/10.2807\/1560-7917.ES.2022.27.22.2200421.","journal-title":"Euro Surveill"},{"key":"1967_CR10","doi-asserted-by":"publisher","DOI":"10.1093\/jtm\/taac082","author":"B Davido","year":"2022","unstructured":"Davido B, D\u2019Anglejan E, Baudoin R, Dahmane L, Chaud A, Cortier M, Fellous CV, De Truchis P, Ghosn J. Monkeypox outbreak 2022: an unusual case of peritonsillar abscess in a person previously vaccinated against smallpox. J Travel Med. 2022. https:\/\/doi.org\/10.1093\/jtm\/taac082. (Epub ahead of print).","journal-title":"J Travel Med"},{"key":"1967_CR11","doi-asserted-by":"publisher","DOI":"10.1016\/S2666-5247(22)00153-7","author":"A Otu","year":"2022","unstructured":"Otu A, Ebenso B, Walley J, Barcel\u00f3 JM, Ochu CL. Global human monkeypox outbreak: atypical presentation demanding urgent public health action [published online ahead of print, 2022 Jun 7]. Lancet Microbe. 2022. https:\/\/doi.org\/10.1016\/S2666-5247(22)00153-7.","journal-title":"Lancet Microbe."},{"key":"1967_CR12","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2207323","author":"JP Thornhill","year":"2022","unstructured":"Thornhill JP, Barkati S, Walmsley S, Rockstroh J, Antinori A, Harrison LB, Palich R, Nori A, Reeves I, Habibi MS, Apea V, Boesecke C, Vandekerckhove L, Yakubovsky M, Sendagorta E, Blanco JL, Florence E, Moschese D, Maltez FM, Goorhuis A, Pourcher V, Migaud P, Noe S, Pintado C, Maggi F, Hansen AE, Hoffmann C, Lezama JI, Mussini C, Cattelan A, Makofane K, Tan D, Nozza S, Nemeth J, Klein MB, Orkin CM, SHARE-net Clinical Group. Monkeypox virus infection in humans across 16 countries\u2014April\u2013June 2022. N Engl J Med. 2022. https:\/\/doi.org\/10.1056\/NEJMoa2207323. (Epub ahead of print).","journal-title":"N Engl J Med"},{"key":"1967_CR13","doi-asserted-by":"publisher","first-page":"o1845","DOI":"10.1136\/bmj.o1845","volume":"378","author":"J Wise","year":"2022","unstructured":"Wise J. Monkeypox: new clinical symptoms are identified in confirmed cases. BMJ. 2022;378:o1845. https:\/\/doi.org\/10.1136\/bmj.o1845.","journal-title":"BMJ"},{"key":"1967_CR14","doi-asserted-by":"publisher","DOI":"10.1177\/09564624221114191","author":"Y Ortiz-Mart\u00ednez","year":"2022","unstructured":"Ortiz-Mart\u00ednez Y, Zambrano-Sanchez G, Rodr\u00edguez-Morales AJ. Monkeypox and HIV\/AIDS: when the outbreak faces the epidemic. Int J STD AIDS. 2022. https:\/\/doi.org\/10.1177\/09564624221114191. (Epub ahead of print).","journal-title":"Int J STD AIDS"},{"key":"1967_CR15","doi-asserted-by":"publisher","DOI":"10.1177\/09564624221114998","author":"D de Sousa","year":"2022","unstructured":"de Sousa D, Patroc\u00ednio J, Frade J, Correia C, Borges-Costa J, Filipe P. Human monkeypox coinfection with acute HIV: an exuberant presentation. Int J STD AIDS. 2022. https:\/\/doi.org\/10.1177\/09564624221114998. (Epub ahead of print).","journal-title":"Int J STD AIDS"}],"container-title":["Infection"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s15010-022-01967-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s15010-022-01967-9\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s15010-022-01967-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,5,23]],"date-time":"2023-05-23T14:38:14Z","timestamp":1684852694000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s15010-022-01967-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,1,13]]},"references-count":15,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2023,6]]}},"alternative-id":["1967"],"URL":"https:\/\/doi.org\/10.1007\/s15010-022-01967-9","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-2290884\/v1","asserted-by":"object"}]},"ISSN":["0300-8126","1439-0973"],"issn-type":[{"value":"0300-8126","type":"print"},{"value":"1439-0973","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,1,13]]},"assertion":[{"value":"19 November 2022","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"15 December 2022","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"13 January 2023","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no conflict of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"The study was conducted according to the guidelines of the Declaration of Helsinki.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical statement"}},{"value":"The patient gave written consent to the use of his clinical information for scientific purposes. No tissues were obtained from prisoners. The material for the skin biopsy was obtained at our clinic of Spedali Civili di Brescia.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"The patient gave written consent to use of clinical information relating to his case to be reported in a medical publication.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to publish statements"}}]}}