Armed Forces Infectious Diseases Society
Infectious Diseases Image Collection

Case 11

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A 41 year-old man with AIDS (CD4 T lymphocyte count, 19 cells/mm3), presented with fevers, nausea, vomiting, abdominal pain, hypotension and signs of sepsis. Pancytopenia was noted on laboratory testing, including a hemoglobin of 6.1 g/dL and platelets of < 20,000 cell/mm3. His chest x-ray was unremarkable, but MRI of his brain showed diffuse ring-enhancing lesions. The diagnosis was made initially on the peripheral blood smear (see images) and was confirmed by additional testing and cultures.

Submitted by Dr. Keith Woeltje and Dr. Nancy Garcia, from the Infectious Disease Service at Medical College of Georgia, Augusta, GA. Images submitted by Robert Kazragis, MD, COL, MC, Infectious Disease Service, Dwight David Eisenhower Army Medical Center, Fort Gordon, GA.


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