Thread by @guerreroespejo

A 39-YO ♂️, same-sex relationships involving condomless anal sex: 38°C, cervical lymphadenopathy, mucosal ulceration on his tongue and a maculopapular rash on his face, neck and anterior chest.
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DOI: doi.org/10.1503/cmaj.2…
#Doctor #emergency #dermatology

RPR: ➖
Immunoassay:➕for HIV antibodies
HIV-1 blood viral load: 4.79 million copies/mL
Blood CD4 T-cell count of 0.1 × 109/L.

ACUTE HIV INFECTION

Started antiretroviral treatment with bictegravir–emtricitabine–tenofovir alafenamide.
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#IDtwitter #microbiology

Features of acute HIV infection occur 2–4 weeks after exposure.
Common presentation includes fever, arthralgia and lymphadenopathy, which may mimic acute mononucleosis.

Seroconversion usually occurs 3–8 weeks after initial infection.
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#virology #MedTwitter

Mucocutaneous ulceration is highly suggestive of acute HIV infection.

Rash occurs in about 50% of patients, It is characterized by small, well-circumscribed, erythematous macules or maculopapules, mainly on the anterior chest.
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#MedStudentTwitter #resident #medicine

The diagnosis of acute HIV infection is often missed:
✔️ owing to the asymptomatic or self-limited nature of the virus, nonspecific signs (such as the rash) or ✔️clinician hesitancy to ask questions about sexual exposure.
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DOI: doi.org/10.1503/cmaj.2…
#MedicalStudents #MedEd