An Italian man was tested positive for COVID-19, monkeypox, and HIV following a short trip to Spain, a study by researchers from the University of Catania reveals.

Authors of the study, published in the peer-reviewed Journal of Infection, state that a 36 years old Italian man developed a high fever, sore throat, fatigue, headache, and a swollen lymph node in the groin area nine days after the trip.

On July 2, the patient was tested positive for COVID-19 and started to develop a rash on his left arm. The following day small, painful vesicles appeared on his body and began to evolve into pustules. On July 5, the patient was admitted to the hospital, where he later tested positive for both monkeypox and HIV-1.

The study authors say this case highlights how monkeypox and COVID-19 symptoms may overlap. Therefore, clinicians should be aware of the possibility of SARS-CoV-2 and monkeypox virus co-infection, particularly in patients with a recent history of travel to monkeypox-outbreak areas.

"Our case emphasizes that sexual intercourse could be the predominant way of transmission. Therefore, complete STI screening is recommended after a diagnosis of monkeypox," the authors conclude.

However, they highlight that there is not enough evidence supporting that this combination of infections may aggravate a patient's condition.

As of August 24, there are 45,535 cases of monkeypox globally, 16,603 of which are reported in the US.

The Centers for Disease Control and Prevention (CDC) data shows that the most common symptoms of monkeypox are rash, reported in 98.6% of cases, tiredness or not feeling well, reported by 72.7% of patients, and fever, developed in 68.9% of cases. Other common symptoms are chills, headache, enlarged lymph nodes, muscle aches, and itching.

According to the CDC, monkeypox can spread to anyone through close, personal, often skin-to-skin contact, including:

Direct contact with monkeypox rash, scabs, or body fluids from a person with monkeypox.

Touching objects, fabrics (clothing, bedding, or towels), and surfaces that have been used by someone with monkeypox.

Contact with respiratory secretions.