Introduction

A 42-year-old man presented to the emergency department with a 1-week history of fever, abdominal pain and diarrhoea with haematochezia. A medical history was significant for untreated AIDS, which he has had for the past 9 years. The only opportunistic infection that he has had in the past was pneumocystis pneumonia. Prior upper and lower endoscopic evaluation for weight loss in 2018 was unremarkable. On examination, he had multiple purple erythematous nodules over his limbs and tongue (figure 1). Abdominal examination was unremarkable. Investigations demonstrated macrocytic anaemia, thrombocytopaenia, HIV viral load 90 900 copies/mL (4.96 log) and a CD4-count of 34 cells/µL. …