Monkey Pox and Chicken Pox Co-infection Managed in a Southern Nigerian Hospital: A Case Report.

• ¹, Department of Internal Medicine, University of Uyo Teaching Hospital, Uyo, Akwa Ibom State , NG

Background:  Monkey  pox  and  Chicken pox have similar presentations, sometimes  causing a diagnostic dilemma. Reports have emerged of co-infections, mostly in the central African region. 
Case Presentation: The index patient is a 23-year-old woman who presented with a 2-week history of a rash which started from her genital and groin area with accompanying vulvar swelling. It was then followed by other rashes involving mainly her face and limbs with some on her trunk. There was also an associated high-grade continuous fever. Rashes were painful, itchy, mostly pustular and monomorphic with associated cervical and axillary lymphadenopathy. There was no history of contact with someone having similar skin lesions or consumption of bushmeat within a month of symptom onset. Following admission, patient had increasing dysuria with some retention due to the discomfort accompanying micturition. Other symptoms present in the course of her illness were headache, mouth sores and sore throat. Polymerase chain reaction (PCR) of her skin lesion sample was positive for both monkey pox virus and chicken pox virus. The patient had a non-reactive screening for human immunodeficiency viral (HIV) infection. She made an uneventful recovery following a course of acyclovir and empirical antibiotics. She was discharged after 12 days of admission with all the symptoms largely resolved, for follow up care on outpatient basis. 
Conclusions: We report a case of monkey pox and chicken pox co-infection in a patient managed in a southern Nigerian hospital, to increase awareness and index of suspicion for the co-existence of both conditions in endemic areas.