Socio-demographic characteristics and sexual behavioral factors of patients with sexually transmittedFigure 2 Detailed picture of an umbilicated pustule with a necrotic centre and surrounded by an inflammatory plaque.

We describe the first 25 persons with HIV diagnosed with MPXV in our hospital in an ongoing outbreak in Spain. Proctitis was the predominant finding in 52%, and MPXV DNA was detected in rectal swabs from 90%. Proctitis and demonstration of MPXV in rectal swabs support the sexual transmission of MPXV.

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Metapneumovirus, Bocavirus, Respiratory syncytial virus, Adenovirus, and Enterovirus), but it was found to be negative. Lung involvement was not detected in thoracic tomography. Hydroxyzine (1 mg/kg/day), systemic methylprednisolone (1 mg/ kg/day), and phenyramine (1 mg/kg/day) treatments given for urticaria were thought to be resistant to treatment. Vitamin D (1,000 U/day) was added empirically to the patient's treatment. The patient's fever did not recur. The patient was discharged on the 5th day, after examinations for COVID-19 returned to normal and urticaria regressed. Overall, the therapy lasted 10 days. After discharge, hydroxyzine and phenyramine treatments were continued to the follow-up visit. On the 10th day, no pathology was observed in the physical examination and laboratory tests in the outpatient clinic control. Then, all medications were discontinued.elIn most pediatric cases, the diagnosis of COVID-19 may be delayed because of the cases presenting as an asymptomatic individual or with rare symptoms such as skin findings initially, or these patients may be missed without any diagnosis. [2][3][4][5] Our case presented with isolated symptoms such as urticarial rash that started suddenly and had fever of 38°C for 1 day, and COVID-19 was not considered by the pediatricians in which it was seen in the first place, and the patient was sent home with an antihistamine. This may pose a risk to ensuring the transmission control of SARS-CoV-2. Clinicians should be more careful in terms of the symptoms and positive physical examination findings of COVID-19 in the pediatric population, especially because of the start of face-to-face education in schools and the removal of restrictions on children.With this presentation, when acute urticaria and/or angioedema is encountered and rarely occurs in the patient, it is of great importance to bring the COVID-19 viral infection to mind and to narrow the contact circle and to treat the disease.