Initial diagnosis of HIV/AIDS in a 56-year-old man with non-healing forearm lesion

BMJ Case Rep. 2013 Nov 18:2013:bcr2013201184. doi: 10.1136/bcr-2013-201184.

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.

Publication types

  • Case Reports

MeSH terms

  • AIDS-Related Opportunistic Infections / diagnosis*
  • AIDS-Related Opportunistic Infections / drug therapy
  • Angiomatosis, Bacillary / diagnosis
  • Angiomatosis, Bacillary / etiology*
  • Anti-Bacterial Agents / therapeutic use*
  • Bartonella Infections / drug therapy
  • Bartonella Infections / etiology*
  • Bartonella quintana / isolation & purification*
  • CD4 Lymphocyte Count
  • Doxycycline / therapeutic use*
  • Forearm / pathology
  • HIV Infections / complications
  • HIV Infections / diagnosis*
  • Humans
  • Immunocompromised Host
  • Male
  • Middle Aged

Substances

  • Anti-Bacterial Agents
  • Doxycycline