# Combination of Mpox With Ocular Involvement, Human Immunodeficiency Virus, and Pulmonary Tuberculosis Resulting in High Mortality: A Report of Two Cases

## TL;DR

This report describes two fatal cases of mpox in Indonesia with eye involvement, HIV, and TB, highlighting the severe risks of co-infections.

## Contribution

The novelty lies in documenting rare fatal cases of mpox with ocular involvement, HIV, and TB in Indonesia.

## Key findings

- Mpox with ocular involvement can lead to severe outcomes like respiratory failure.
- Co-infections with HIV and TB significantly increase the risk of mpox-related mortality.
- Early recognition and treatment of mpox may improve patient outcomes.

## Abstract

Mpox is a reemerging zoonotic viral disease that has been declared a public health emergency. Ocular symptoms of mpox include pain, redness, tearing, discharge, swelling, and vision impairment. This report describes two cases of mpox with ocular involvement in Indonesia, where the patients had a history of multiple male partners (men who have sex with men (MSM)), human immunodeficiency virus (HIV), and tuberculosis (TB). The first case was a 28-year-old male patient with multiple scabs, including in the eye area, shown as right-eye blepharoconjunctivitis. Despite treatment with tecovirimat, he died from respiratory failure. The second case involved a 25-year-old male patient with similar symptoms and blepharoconjunctivitis in both eyes. He did not receive tecovirimat and also died from respiratory failure. Mpox can severely affect organs, including the eyes. The risk of mpox fatality increases with HIV and TB co-infection. Early recognition of the disease signs may improve the prognosis.