title: Initial diagnosis of HIV/AIDS in a 56-year-old man with non-healing forearm lesion.
abstract: A 56-year-old Hispanic man with no significant medical problems presented with a 2-month history of a non-healing right forearm lesion that progressed despite several courses of empiric antibiotics. The patient underwent incision and drainage. Warthin-Starry stain with immunohistochemistry testing diagnosed bacillary angiomatosis secondary to Bartonella quintana. Subsequently, the patient was diagnosed with HIV, with a CD4 count of 68 cells/mm(3), and a HIV viral load of 47, 914 copies/mL. The patient was treated with doxycycline and started on antiretroviral therapy. The lesion has resolved and he has had no recurrence after 16 months of treatment.
authors.affiliation: Department of Infectious Diseases, Yale University School of Medicine, New Haven, Connecticut, USA.
authors.forename: Heidi J
authors.initials: HJ
authors.lastname: Zapata
authors.forename: Merceditas
authors.initials: M
authors.lastname: Villanueva
authors.forename: Sheela
authors.initials: S
authors.lastname: Shenoi
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis* / Q000188:drug therapy; D016917:Angiomatosis, Bacillary / Q000175:diagnosis / Q000209:etiology*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001474:Bartonella Infections / Q000188:drug therapy / Q000209:etiology*; D018413:Bartonella quintana / Q000302:isolation & purification*; D018791:CD4 Lymphocyte Count; D004318:Doxycycline / Q000627:therapeutic use*; D005542:Forearm / Q000473:pathology; D015658:HIV Infections / Q000150:complications / Q000175:diagnosis*; D006801:Humans; D016867:Immunocompromised Host; D008297:Male; D008875:Middle Aged
chemical_list: D000900:Anti-Bacterial Agents; D004318:Doxycycline