A Multimodal Treatment Strategy to Manage Severe Cutaneous Mpox

A 33-year-old bisexual man with advanced HIV and severe mpox developed severe cutaneous disease despite receiving tecovirimat, antiretroviral therapy, and vaccinia immune globulin. His condition improved after he received topical, intralesional, and intravenous cidofovir and debridement of his mpox...

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Main Authors: Navin Bhatt, John Winters, Yusra Shah, Victoria E. Ruiz, Ofole Mgbako, Marcia Wong, Madeline A. DiLorenzo
Format: Article
Language:English
Published: American College of Physicians 2024-12-01
Series:Annals of Internal Medicine: Clinical Cases
Online Access:https://www.acpjournals.org/doi/10.7326/aimcc.2024.0282
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author Navin Bhatt
John Winters
Yusra Shah
Victoria E. Ruiz
Ofole Mgbako
Marcia Wong
Madeline A. DiLorenzo
author_facet Navin Bhatt
John Winters
Yusra Shah
Victoria E. Ruiz
Ofole Mgbako
Marcia Wong
Madeline A. DiLorenzo
author_sort Navin Bhatt
collection DOAJ
description A 33-year-old bisexual man with advanced HIV and severe mpox developed severe cutaneous disease despite receiving tecovirimat, antiretroviral therapy, and vaccinia immune globulin. His condition improved after he received topical, intralesional, and intravenous cidofovir and debridement of his mpox lesions, but he required a 7-month hospitalization. His treatment was complicated by acute kidney injury secondary to cidofovir, so his antiretroviral therapy was switched to brincidofovir to complete treatment. All his lesions eventually resolved, but he eventually developed stage IV chronic kidney disease, likely due to cidofovir-related nephrotoxicity. Further research should investigate how to best balance the efficacy of severe mpox treatment with secondary effects.
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publisher American College of Physicians
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series Annals of Internal Medicine: Clinical Cases
spelling doaj-art-930367a1b84d4b508e37b53969cfb3ec2025-08-20T02:27:45ZengAmerican College of PhysiciansAnnals of Internal Medicine: Clinical Cases2767-76642024-12-0131210.7326/aimcc.2024.0282A Multimodal Treatment Strategy to Manage Severe Cutaneous MpoxNavin Bhatt0John Winters1Yusra Shah2Victoria E. Ruiz3Ofole Mgbako4Marcia Wong5Madeline A. DiLorenzo61Department of Medicine, New York City Health + Hospitals/Elmhurst, Icahn School of Medicine at Mount Sinai, Elmhurst, New York2Division of Infectious Diseases, Department of Medicine, New York City Health + Hospitals/Elmhurst, New York, New York4Division of Infectious Diseases, Department of Medicine, New York City Health + Hospitals/Bellevue, New York, New York6New York City Department of Health and Mental Hygiene, New York, New York4Division of Infectious Diseases, Department of Medicine, New York City Health + Hospitals/Bellevue, New York, New York6New York City Department of Health and Mental Hygiene, New York, New York4Division of Infectious Diseases, Department of Medicine, New York City Health + Hospitals/Bellevue, New York, New YorkA 33-year-old bisexual man with advanced HIV and severe mpox developed severe cutaneous disease despite receiving tecovirimat, antiretroviral therapy, and vaccinia immune globulin. His condition improved after he received topical, intralesional, and intravenous cidofovir and debridement of his mpox lesions, but he required a 7-month hospitalization. His treatment was complicated by acute kidney injury secondary to cidofovir, so his antiretroviral therapy was switched to brincidofovir to complete treatment. All his lesions eventually resolved, but he eventually developed stage IV chronic kidney disease, likely due to cidofovir-related nephrotoxicity. Further research should investigate how to best balance the efficacy of severe mpox treatment with secondary effects.https://www.acpjournals.org/doi/10.7326/aimcc.2024.0282
spellingShingle Navin Bhatt
John Winters
Yusra Shah
Victoria E. Ruiz
Ofole Mgbako
Marcia Wong
Madeline A. DiLorenzo
A Multimodal Treatment Strategy to Manage Severe Cutaneous Mpox
Annals of Internal Medicine: Clinical Cases
title A Multimodal Treatment Strategy to Manage Severe Cutaneous Mpox
title_full A Multimodal Treatment Strategy to Manage Severe Cutaneous Mpox
title_fullStr A Multimodal Treatment Strategy to Manage Severe Cutaneous Mpox
title_full_unstemmed A Multimodal Treatment Strategy to Manage Severe Cutaneous Mpox
title_short A Multimodal Treatment Strategy to Manage Severe Cutaneous Mpox
title_sort multimodal treatment strategy to manage severe cutaneous mpox
url https://www.acpjournals.org/doi/10.7326/aimcc.2024.0282
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