A 40-year-old man has been bothered by oral candidiasis, fever, and diarrhea for the past year. On physical examination, he has muscle wasting. His weight is 70% of normal for his height and age. He has generalized nontender lymphadenopathy, but no hepatosplenomegaly. He developed three irregular, 1- to 2-cm, reddish-purple, nodular skin lesions on his forearm in the past 3 months. Laboratory findings show hemoglobin, 12.2 g/dL; hematocrit, 36.5%; MCV, 85 mm3; platelet count, 188,000/ mm3; and WBC count, 2460/ mm3 with 82% segmented neutrophils, 4% bands, 6% lymphocytes, 6% monocytes, and 2% eosinophils. Infection with which of the following organisms is most likely to produce these findings?
Correct Answer: HIV
Description: The reddish-purple lesions are typical of Kaposi sarcoma in a patient with wasting syndrome, oral thrush, and lymphopenia characteristic of HIV infection with AIDS. Hepatitis C virus is unlikely to produce skin lesions or lymphopenia of this degree. Herpes simplex virus infections may be seen more frequently in HIV infection, but the lesions are typically vesicular and are located in the perioral or perianal regions. Hansen disease, caused by Mycobacterium leprae infection, may produce a faint reddish rash that fades, followed by hypopigmentation or anesthesia of affected skin and sometimes nodular deforming lesions developing over years. Staphylococcal skin infections tend to produce localized abscesses, such as furuncles and boils. Streptococcal skin infections may manifest as abscesses or as cellulitis.
Category:
Pathology
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