Background: 
Monkeypox, caused by the Monkeypox virus (MPV), is a double-stranded DNA virus belonging to the genus Orthopoxvirus. While confirmed cases of Mpox disease have been reported in since the 1970s, the recent global outbreak has escalated Monkeypox to a public health emergency. Although Monkeypox is typically considered a self-limiting disease, the recent outbreak has demonstrated an increase in disease morbidity and mortality, particularly in those with immunocompromised status. For those with HIV infection, co-infection with Monkeypox can lead to atypical disease presentation. This poster highlights an example of a highly atypical dermatological presentation in a patient with HIV and Monkeypox co-infection. 

Discussion: A 28-year-old male with a history of untreated HIV/AIDS presented with diffuse bilateral eschars with well-extended surrounding erythema for two days. The lesions were expansive and located diffusely across the bilateral upper extremities. The patient reported the lesions were slowly enlarging and mildly pruritic. Additionally, bilateral tender inguinal lymphadenopathy and a single painful shallow ulcer on the right-side penile shaft was present. While Monkeypox typically presents with small well-localized eschars surrounded by slight erythema, this patient demonstrated well-extended erythema and diffuse eschars on the bilateral upper extremities. This case illustrates that HIV and Monkeypox co-infection may lead to exacerbation of the typical symptoms of each disease– resulting in atypical dermatologic presentations, unique disease manifestations, and more difficult management. 


Rare presentation of Monkeypox in a Patient with Coexisting HIV

Healthcare disparities in the United States lead to nearly $35 billion in excess health expenditures annually and can include increased risks of surgical complications and mortality among at-risk patients. However, these disparities have yet to be clearly elucidated within the field of orthopedic surgery. Moreover, minority populations receive poor trauma care and increased complications after spine surgical & joint replacement surgeries. This study aims to highlight the current disparities in orthopedics and provide strategies to decrease these discrepancies to provide equitable medical care. To accomplish this, we conducted a systematic review of the clinical, functional, and quality of life measures in relation to healthcare disparities in the field of orthopedics. Using the recommendations outlined in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), we screened studies in language, race, transportation, and orthopedic trauma coverage and extracted current data to synthesize strategies to reduce disparities. Preliminary analysis indicates lack of access to reliable and robust public transit infrastructure interrupts the continuity of care and produces worse health outcomes, specifically in Hispanic populations. Additionally, disparities based on language demonstrate a difference in the outcomes of their care. With regards to trauma coverage, uninsured and minority populations experienced more iatrogenic complications, had an increased risk of major adverse events, longer wait times, and lower chances of undergoing surgery resulting in more major adverse events. These results underscore the need for educational interventions to improve patient follow-up care in orthopedic settings.

Current Strategies for Decreasing Disparities in Orthopaedic Care: A Systematic Review

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AMA Research Challenge 2022

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Rare presentation of Monkeypox in a Patient with Coexisting HIV

Current Strategies for Decreasing Disparities in Orthopaedic Care: A Systematic Review

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