{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T08:01:58Z","timestamp":1781596918023,"version":"3.54.5"},"reference-count":50,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2023,8,23]],"date-time":"2023-08-23T00:00:00Z","timestamp":1692748800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"RicercaCorrente Linea 1 and 2"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pathogens"],"abstract":"<jats:p>Since May 2022, a global outbreak of human Mpox has rapidly spread in non-endemic countries. We report a case of a 34-year-old man admitted to hospital for a six-day history of fever associated with vesiculo-pustular rash involving the face, limbs, trunk and perianal region, lymphadenopathy and severe proctitis and pharyngitis. He was HIV-positive and virologically suppressed by stable antiretroviral therapy. On admission, Mpox virus-specific RT-PCR was positive from multiple samples. Additionally, blood cultures yielded Streptococcus pyogenes, prompting a 14-day-course of penicillin G and clindamycin. Due to the worsening of proctitis along with right ocular mucosa involvement, tecovirimat treatment was started with a rapid improvement in both skin and mucosal involvement. The patient was discharged after 21 days of hospitalization and the complete clinical resolution occurred 38 days after symptom onset. This is a case of Mpox with extensive multi-mucosal (ocular, pharyngeal and rectal) and cutaneous extension and S. pyogenes bacteraemia probably related to bacterial translocation from the skin or oral cavity that was eased by Mpox lesions\/inflammation. The HIVinfection, although well controlled by antiretroviral therapy, could have played a role in the severe course of Mpox, suggesting the importance of a prompt antiviral treatment in HIV-positive patients.<\/jats:p>","DOI":"10.3390\/pathogens12091073","type":"journal-article","created":{"date-parts":[[2023,8,23]],"date-time":"2023-08-23T07:25:24Z","timestamp":1692775524000},"page":"1073","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["A Case of Severe Mpox Complicated with Streptococcus pyogenes Sepsis in a Patient with HIV Infection"],"prefix":"10.3390","volume":"12","author":[{"given":"Silvia","family":"Di Bari","sequence":"first","affiliation":[{"name":"National Institute for Infectious Diseases \u2018Lazzaro Spallanzani\u2019 (IRCCS), 00149 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annalisa","family":"Mondi","sequence":"additional","affiliation":[{"name":"National Institute for Infectious Diseases \u2018Lazzaro Spallanzani\u2019 (IRCCS), 00149 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmela","family":"Pinnetti","sequence":"additional","affiliation":[{"name":"National Institute for Infectious Diseases \u2018Lazzaro Spallanzani\u2019 (IRCCS), 00149 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0240-7504","authenticated-orcid":false,"given":"Valentina","family":"Mazzotta","sequence":"additional","affiliation":[{"name":"National Institute for Infectious Diseases \u2018Lazzaro Spallanzani\u2019 (IRCCS), 00149 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1952-5117","authenticated-orcid":false,"given":"Fabrizio","family":"Carletti","sequence":"additional","affiliation":[{"name":"National Institute for Infectious Diseases \u2018Lazzaro Spallanzani\u2019 (IRCCS), 00149 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2948-4243","authenticated-orcid":false,"given":"Giulia","family":"Matusali","sequence":"additional","affiliation":[{"name":"National Institute for Infectious Diseases \u2018Lazzaro Spallanzani\u2019 (IRCCS), 00149 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donatella","family":"Vincenti","sequence":"additional","affiliation":[{"name":"National Institute for Infectious Diseases \u2018Lazzaro Spallanzani\u2019 (IRCCS), 00149 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6351-2623","authenticated-orcid":false,"given":"Roberta","family":"Gagliardini","sequence":"additional","affiliation":[{"name":"National Institute for Infectious Diseases \u2018Lazzaro Spallanzani\u2019 (IRCCS), 00149 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raffaele","family":"Santoro","sequence":"additional","affiliation":[{"name":"National Institute for Infectious Diseases \u2018Lazzaro Spallanzani\u2019 (IRCCS), 00149 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2198-1947","authenticated-orcid":false,"given":"Carla","family":"Fontana","sequence":"additional","affiliation":[{"name":"National Institute for Infectious Diseases \u2018Lazzaro Spallanzani\u2019 (IRCCS), 00149 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabrizio","family":"Maggi","sequence":"additional","affiliation":[{"name":"National Institute for Infectious Diseases \u2018Lazzaro Spallanzani\u2019 (IRCCS), 00149 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8182-5896","authenticated-orcid":false,"given":"Enrico","family":"Girardi","sequence":"additional","affiliation":[{"name":"National Institute for Infectious Diseases \u2018Lazzaro Spallanzani\u2019 (IRCCS), 00149 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Vaia","sequence":"additional","affiliation":[{"name":"National Institute for Infectious Diseases \u2018Lazzaro Spallanzani\u2019 (IRCCS), 00149 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2121-4684","authenticated-orcid":false,"given":"Andrea","family":"Antinori","sequence":"additional","affiliation":[{"name":"National Institute for Infectious Diseases \u2018Lazzaro Spallanzani\u2019 (IRCCS), 00149 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,8,23]]},"reference":[{"key":"ref_1","unstructured":"(ICTV) ICoToV (2023, June 29). 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