A 37-year-old Thai man with HIV was diagnosed with monkeypox Clade 1b after sexual contact with a foreign partner, confirmed through PCR testing and treated with antiviral medication.
On July 21, 2025, Dr. Manoon Leechaivanvong, a respiratory specialist at Vichaiyu Hospital, shared a case of a 37-year-old Thai male patient who visited a doctor on July 16, 2025, presenting with fever, chills, body aches, and fatigue lasting three days. After the fever subsided, small pustules appeared on his face, chest, abdomen, back, sides, hands, arms, legs, genitals, and perianal area, with no lesions on the eyes or mouth.
One month prior, the patient had sexual contact with a foreign man. He has a history of HIV infection and has been taking antiretroviral therapy continuously for 15 years with good viral control. He had previously contracted syphilis. Physical examination showed no fever and enlarged lymph nodes in both groins. Small pustules were scattered across the face, hands, torso, arms, legs, genitals, and perianal area.
PCR testing of fluid samples from the pustules and the upper surface of lesions confirmed monkeypox (MPOX) Clade 1b. Diagnosis: MPOX Clade 1b and HIV infection. The patient was prescribed Tecovirimat antiviral medication twice daily for two weeks, as he is in a high-risk group with HIV infection. He tolerated the medication well without adverse reactions, and the pustules reduced in size after treatment. The patient lives alone and was advised to self-isolate at home for three weeks until the skin completely scabs over and new skin covers all affected areas, to prevent transmission of monkeypox to others.