Fatal case of community-acquired pneumonia coinfected with monkeypox virus: clinical and autopsy findings

December 10, 2024
Clinical Microbiology
Anselmo Abdo, Sergio Rabell, Fidel Simón, Zaddy Quintero, María C de Armas, Namibia Espinosa, Lianet Quiles, Ileana Paneque, Karel Duran, Genny Martínez, Luis M Pérez, Yenisey Pérez, Roberto Castellanos
Pathogen:Monkeypox virus
Infection Type:Community-acquired pneumonia
Pathogen Type:Virus

Summary

A 31-year-old male, HIV-positive and unvaccinated for monkeypox (Mpox), presented with fever, cough, dyspnea, and a maculopapular rash, rapidly progressing to respiratory failure and death. Initial diagnosis was community-acquired pneumonia, but autopsy revealed extensive lung damage and systemic Mpox infection confirmed by PCR in multiple organs, alongside a bacterial coinfection (Klebsiella pneumoniae) in the lungs. This case highlights the severe and fatal outcomes of Mpox, particularly in immunocompromised individuals, when complicated by secondary bacterial pneumonia. The rapid progression underscores the need for early diagnosis and aggressive management in vulnerable populations.

Key note: Mpox can lead to fatal outcomes in immunocompromised patients, especially with secondary bacterial pneumonia, necessitating prompt diagnosis and treatment.

DOI: 10.1128/asmcr.00024-24