Human immunodeficiency virus (HIV) infection Quiz: Ace Your Exams
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A 32-year-old man presents to the clinic with a two-week history of fever, fatigue, night sweats, and unintentional weight loss of 5 pounds. He also reports sore throat, myalgias, and a non-pruritic maculopapular rash on the trunk. He has not travelled recently, had tick bites, or had exposure to sick contacts. Past medical history is significant for genital herpes. The patient has had multiple sexual partners and inconsistent use of condoms for several years. He does not use recreational substances. Temperature is 38°C (100.4°F), pulse is 88/min, respiratory rate is 14/min, blood pressure is 126/84 mmHg, and oxygen saturation is 99% on room air. Examination of the skin reveals a diffuse maculopapular rash on the trunk and extremities. Cervical lymphadenopathy is present bilaterally. Oral examination shows erythema of the pharynx without exudates or tonsillar swelling. There are no genital lesions or penile discharge. Laboratory results are shown below. Which of the following is the most likely diagnosis?
| Laboratory value | Result |
| Hemoglobin | 12 g/dL |
| Hematocrit | 40 % |
| Leukocyte count | 3,100/mm3 |
| Platelet count | 150,000/mm3 |
| Alanine aminotransferase (ALT) | 58 U/L |
| Aspartate aminotransferase (AST) | 78 U/L |
| Heterophile antibody | Negative |
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