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Fever and generalised lymphadenopathy in an HIV-positive patient: a diagnostic challenge
  1. Bernardo Neves1,
  2. Pedro Raimundo1,
  3. Pedro Farinha2
  1. 1Internal Medicine, Hospital da Luz, Lisboa, Lisboa, Portugal
  2. 2Pathology Anatomy, Centro Hospitalar de Lisboa Central EPE, Lisboa, Lisboa, Portugal
  1. Correspondence to Dr Pedro Raimundo, p_oliveiraraimundo{at}


Fever and generalised lymphadenopathy is a common presentation of a variety of diseases and a thorough investigation is often necessary for appropriate diagnosis.

We present a 53-year-old male patient admitted with fever, weight loss of 15 kg in 3 months and abdominal discomfort. Examination was only remarkable for axillary and inguinal lymphadenopathy. Blood tests showed normocytic normochromic anaemia, cholestasis and a previously unknown HIV-1 infection with lymphocyte CD4 +count of 239 cells/mm3 and viral load 3.172.370 copies/mL. A body CT scan showed multiple axillary, mediastinal, lumbar, aortic, iliac and pelvic lymphadenopathy as well as hepatosplenomegaly. An excisional biopsy of the left axillary lymphadenopathy was performed and histology ultimately revealed multicentric Castleman’s disease associated with Human Herpes Virus-8. After initiation of antiretroviral therapy, rituximab was given and progressive clinical improvement occurred.

  • infections
  • haematology (drugs and medicines)
  • HIV / AIDS
  • malignant and benign haematology

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  • Contributors BN has written the majority of this paper and had the greatest contribution (70%). PR reviewed the paper and contributed with some parts (20%). PF contributed with some parts of the paper (10%).

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.