HIV and AIDS Quiz: Ace Your Exams

A 26-year-old woman comes to the clinic for evaluation of pain with swallowing. The patient reports a burning sensation with swallowing both solids and liquids and noticed white patches in the back of her throat. Two months ago, she was diagnosed with Chlamydia trachomatis and treated with ceftriaxone and oral doxycycline. Past medical history includes IgA nephropathy. The patient is sexually active and uses condoms inconsistently. Temperature is 38.11°C (100.6°F), pulse is 99/min, respirations are 20/min, and blood pressure is 120/75 mmHg. Physical examination reveals anterior and posterior cervical lymphadenopathy. Lungs are clear on auscultation. The abdomen is soft and nontender. Oral examination reveals dental caries and white posterior pharyngeal mucosal plaques. An external genital examination is noncontributory. She is initiated on oral fluconazole. One month later, she revisits the clinic with worsening dysphagia. An endoscopy is performed, which reveals large, ovoid punched out ulcers throughout the esophagus. Which of the following is most likely to be found on further evaluation?