A Case Report of Mpox-varicellar-zoster Co-infection In a Diabetic Patient In a Tertiary Hospital In Southeast, Nigeria

Francis Idenyi Onwe; Eric Okorie Nwaze; Obinna Ogbonnaya Oyazi; Ngozika Juliet Nwachukwu; Uzochukwu Ofonakara; Uzoma Maryrose Agwu; Nwambeke Ogbonna Nwambeke

doi:10.5455/CRSM.20250325052807

Abstract
This case report is about an unusual case of Mpox disease which was managed in a teaching hospital aimed at increasing the understanding of mpox disease when there are co-morbidities on the patient. Health workers will have a higher index of suspicion and be able to manage such cases better.
On 30th January, 2025, a 50-year-old woman presented at the A & E department with: Fever, chills and Rigors of 8 days and generalized body rash for 6 days, breathing difficulties, cough and blisters of 2 days duration. No history of recent travel though had contact with her son who returned recently from another state. She is a known diabetic patient who was not compliant with her medication
On examination, an elderly, restless woman with generalized maculo-papular and vesiculo-pustular skin rashes, dehydrated, T:36.70c, PR:83b/m, BP:130/70mmHg, RR:38counts/minute, SPO2:94%. Chest: Breath sound-Vesicular with stridor. An impression of Mpox was made to rule out Sepsis. Basic laboratory investigations were carried out. She was rehydrated, started on antibiotics, analgesics, hypoglycemic agents, O2 and was referred.
A specimen sample sent to Nigeria Centre for Disease Control reference PCR laboratory showed positive result for MPox virus and Varicella zoster.
A confirmed case of MPox disease co-existing with Varicella zoster in a diabetic patient, the need for increased index of suspicion. The patient passed on a few days later.

Key words: Key Words: MPox, Varicella-Zoster, Diabetics Mellitus, Co-infection, Southeast, Nigeria.