Clinical outcome was favorable after 90 days of tecovirimat treatment and administration of human vaccinia immunoglobulins.
We report successful management of persistent disseminated mpox having nodular liver and bilateral lung involvement in an immunosuppressed patient co-infected with HIV and hepatitis B virus (HBV).
The foot lesion sample was positive for monkeypox virus (MPXV) by PCR (cycle threshold 13.47) (Appendix Figure).
Follow-up positron emission tomography/CT scan and MRI showed reduced lung and liver lesions (Figure, panels C, D).
Thus, we continued tecovirimat treatment for the maximum US Food and Drug Administration–approved duration of 90 days without adverse effects.

Mpox Hepatic and Pulmonary Lesions in HIV/Hepatitis B Virus Co-Infected Patient, France