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A 39-year-old man presented with a history of fatigue, malaise, and rash with varied morphology on his perianal region. Polymerase chain reaction testing of the lesions confirmed coinfection with monkeypox and herpes simplex virus type 2. We emphasize the difficulty in distinguishing between monkeypox virus and herpes simplex virus type 2 based on history and examination alone.
Financial support: This study was funded by the UCLA Department of Pathology and Laboratory Medicine.
Authors’ addresses: Kavitha K. Prabaker, Annabelle de St. Maurice, and Daniel Z. Uslan, Department of Clinical Epidemiology and Infection Prevention, UCLA David Geffen School of Medicine, Los Angeles, CA, E-mails: kprabaker@mednet.ucla.edu, adestmaurice@mednet.ucla.edu, and duslan@mednet.ucla.edu. George C. Yen, Department of Internal Medicine, UCLA David Geffen School of Medicine, Los Angeles, CA, E-mail: gcyen@mednet.ucla.edu. Shadi Manavi, UCLA Health Primary Care Network, Los Angeles, CA, E-mail: srafael@mednet.ucla.edu. Hannah K. Gray, J. R. Caldera, June L. Chan, Omai B. Garner, and Shangxin Yang, Department of Pathology and Laboratory Medicine, UCLA David Geffen School of Medicine, Los Angeles, CA, E-mails: hkgray@mednet.ucla.edu, jfcaldera@mednet.ucla.edu, junechan@mednet.ucla.edu, ogarner@mednet.ucla.edu, and shangxinyang@mednet.ucla.edu.