An AIDS Patient with Fever and Rash

Abstract

A 45-year-old man with late-stage AIDS was admitted to the hospital because of fever and a progressive wasting syndrome. Although the patient had traveled extensively throughout Central America and South America and had lived in Panama 20 years earlier, his current illness kept him housebound, and he had no recent travel history or disease exposures. Two weeks before admission to the hospital, he had developed a painful erythematous swelling over his right elbow, which was followed several days later by the development of a tender erythematous nodule on his middle finger (figure 1) and multiple monomorphic, dome-shaped papules and nodules localized to his head and neck (figure 2). The findings of an oral examination were notable for poor dentition, with an abscessed upper molar. His WBC and platelet counts were 400 cells/mm3 and