Chronic Mpox Infection

A 36-year-old man who has sex with men, recently diagnosed with HIV, presented with progressively worsening multiple large skin ulcers. The initial symptoms, beginning as genital ulcers, appeared 2 weeks after unprotected intercourse with an anonymous male partner and later spread throughout the body. Hematologic analysis revealed a CD4 count of 1.3 × 108 cells/L. Syphilis serologies were reflective of serofast state with known previous treatment. Skin biopsies ruled out fungal, mycobacterial, or malignant conditions. Four weeks after admission, new vesicles appeared on his right arm. Mpox was eventually confirmed by polymerase chain reaction, indicating chronic mpox infection.