(CS-092) Treatment of Monkeypox Complicated with Pseudomonas Aeruginosa, Herpes Simplex, and Corynebacterium in a Patient with HIV: A Case Study

Lajonia Anderson, RN, BSN, WCN, OMS; Daniel Mounsey, RN, WCT, OMS; Victoria Sheesley, Pt, DPT, WCC, CLT; Alicia Smith, PT, DPT, CWS, NCS

Introduction: Monkeypox was first recognized in 1970 in the Democratic Republic of the Congo. However, on July 23, 2022, the WHO declared an outbreak of monkeypox a Public Health Emergency of International Concern following an LGBT+ Pride event held on the Spanish island of Gran Canaria. Presently, monkeypox is an emerging virus characterized by pustular lesions congregating around the oral and anogenital regions and rarely spreading to the entire body. Patients with monkeypox may present with fever, fatigue, lymphadenopathy, and severe pain.

Methods: We herein report a rare case of a 36-year-old male diagnosed with monkeypox complicated by Pseudomonas aeruginosa, Corynebacterium, and herpes simplex bacteria on cultures with a recent admission for Pneumocystis Jiroveci requiring intubation. His symptoms on this admission include adenopathy, lesions covering 20-30% of his body, fevers, and severe pain. Using a multidisciplinary approach, including dermatology, specialized immunology and others, multiple treatment modalities were trialed.

Results: At the start of treatment, the clinician attempted to use an antiviral ointment, antimicrobial soaks, and antimicrobial ointments with no sign of improvement in lesions. However, the clinician eventually observed positive results upon using a combination of an enzymatic ointment and an antimicrobial foam with hydrocolloid rings surrounding moist wounds with gauze to secure and enzymatic ointment and an antimicrobial foam with barrier cream with gauze to secure for dry lesions. The patient had a resolution of an estimated 90% of lesions on day 64 of treatment.

Discussion: This p</span>atient benefited from using a combination of enzymatic ointment, antimicrobial foam, and hydrocolloid rings. However, there is a need for more studies into the treatment of monkeypox lesions, especially those cases complicated with comorbidities including HIV or AIDS and concomitant bacterial infections.

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References: Dries DJ. Monkeypox. Air Med J. 2022 Nov-Dec;41(6):510-514. doi: 10.1016/j.amj.2022.09.007.

Epub 2022 Nov 11. PMID: 36494162; PMCID: PMC9650970.

Mitjà O, Ogoina D, Titanji BK, Galvan C, Muyembe JJ, Marks M, Orkin CM. Monkeypox. Lancet.

2023 Jan 7;401(10370):60-74. doi: 10.1016/S0140-6736(22)02075-X. Epub 2022 Nov 17.

Erratum in: Lancet. 2022 Dec 3;400(10367):1926. PMID: 36403582; PMCID:

PMC9671644.