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Generalised maculopapular rash and multiple nodular pulmonary lesions in an HIV-infected man

2009; BMJ; Volume: 64; Issue: 2 Linguagem: Inglês

10.1136/thx.2008.098178

1468-3296

Luca Meroni, S Trovati, S. Antinori,

Eosinophilic Disorders and Syndromes

Generalised maculopapular rash and multiple nodular pulmonary lesions in an HIV-infected man CLINICAL PRESENTATIONA 41-year-old heterosexual man with a recently diagnosed HIV infection was admitted to our department complaining of a 5month history of malaise, non-productive cough and a weight loss of 8 kg.He was a non-intravenous drug user.On physical examination he had a generalised maculopapular rash which was more prominent on the trunk and arms and included the palms and soles (fig 1).Physical examination of the heart, lungs and abdomen was normal.The CD4 count was 176 cells/ml and the plasma HIV-RNA was 4.3 log copies/ml.The results of blood screening laboratory tests were normal.Chest radiography showed multiple bibasilar pulmonary nodules while a CT scan of the lungs showed a wide area of increased density with irregular margins located in the right inferior pulmonary lobe (fig 2).A tuberculin skin test was negative.Cytological examinations of bronchoalveolar lavage (BAL) fluid did not show malignant cells.Gram, PAS, Ziehel-Neelsen and Warthin-Starry stains of specimens from lung brushing and transbronchial biopsy did not reveal infectious agents.Cultures