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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. …
Contributors SSDT drafted and edited the manuscript. KPC provided overall clinical supervision. ASYS performed the endoscopic procedures and edited the manuscript. NWCK provided help with the histology component of the manuscript.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.