title: A horse in zebra stripes: a peculiar case of undetected end-stage AIDS.
abstract: OBJECTIVE
  Late HIV diagnosis occurs in up to 45% of new HIV cases in the developed world and is linked to worse health outcomes, including more hospitalizations, higher health care resource utilization and less robust responses to highly active antiretroviral therapy.
  
  
  METHODS
  Case report
  
  
  RESULTS
  A 70-year-old woman with an obscure constellation of medical and psychiatric complaints ultimately proved to have end-stage acquired immunodeficiency syndrome discovered much too late. Curiously, she had no obvious risk factors for HIV infection.
  
  
  CONCLUSIONS
  This tragic case underscores the importance of keeping HIV infection in the differential for a patient with diverse vague complaints. Let this story caution its readers: when you hear hoof beats, do not look for zebras - even when you are least expecting a horse.
authors.affiliation: Mayo Clinic, Rochester, MN 55905. Electronic address: kei.yoshimatsu@ucsf.edu.
authors.forename: Kei
authors.initials: K
authors.lastname: Yoshimatsu
authors.affiliation: Mayo Clinic, Rochester, MN 55905. Electronic address: bostwick.john@mayo.edu.
authors.forename: J Michael
authors.initials: JM
authors.lastname: Bostwick
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000150:complications / Q000175:diagnosis*; D000368:Aged; D057210:Delayed Diagnosis; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000209:etiology; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007970:Leukopenia / Q000209:etiology; D019964:Mood Disorders / Q000209:etiology; D019562:Viral Load
keywords: AIDS; Depression; HIV; HIV-associated dementia; Mood disorder