A 43-year-old man comes to the clinic due to fever

A 43-year-old man comes to the clinic due to fever, night sweats, fatigue, and progressive skin lesions. The pati ent says the skin lesions started

as small, reddish/purple papules that gradually enlarged to large nodules. He has a history of HIV and is not compliant with antiretroviral therapy

or prophylactic antimicrobials. His last CD4 count 3 months ago was 50/mm3. He has been hospitalized in the past for Pneumocystis pneumonia.

The patient is homeless and primarily lives outdoors but sometimes stays in shelters. Temperature is 38 C (100.4 F), blood pressure is 116/70 mm

Hg, and pulse is 92/min. The patient is cachectic. White plaques are present on his palate. Hepatosplenomegaly is present. Skin examination

shows several purple, pedunculated lesions on the face and extremities that are friable and bleed easily with palpation. CT scan of the abdomen

reveals hypodense liver lesions that enhance with intravenous contrast. Which of the following is the most likely cause of this patient’s current

systemic illness?

  • QA Bartonella species
  • 0 B. Candida species
  • 0 C . Cytomegalovirus
  • 0 D. Mycobacterium avium complex
  • 0 E. Nocardia species
  • 0 F Pneumocystis jirovecii (former ly P carinil)
  • 0 G. Pox virus

0 voters


Key A
Bacillary angiomatosis
Common in immunocompromise