Given this patient's acute onset of presentations including typical skin lesions/umbilicated papules following a recent exposure to monkeypox virus [2], well‐controlled HIV infection with a normal CD4(+) T‐cell count, unknown status of initial versus resolving HSV1 infection, bacterial tonsillitis that is less likely to elicit atypical/reactive lymphocytes, and lack of clinical pharyngitis, atypical/reactive lymphocytes in this case were likely associated with acute monkeypox virus infection. This evidence concerns the gene CD4 and HIV infectious disease.