LAUSR

A 40-year-old woman, who was a farmer, was admitted to hospital in May 2010 for interrupted fever for 3 months, multiple umbilicated papules, nodules, with necrosis and crusts on her face, trunk, scalp and extremities for 2 months (Fig. 1a). The patient had lost 15 kg in weight in 1 year, and she had a history of TB, thrombocytopenia and recurrent herpes zoster during the past 3 years. Her HIV antibodies were confirmed positive on 8 January 2010 and the baseline CD4þ cell count was 20 cells/ml. Investigation revealed platelet (PLT) was 8 10 cells/l, splenomegaly and histopathological examination of skin papule showed the presence of lymphocytic infiltration and other inflammatory cells (Fig. S1A, http://links. lww.com/QAD/B141). Periodic acid Schiff stain revealed yeast cells (Fig. S1B, http://links.lww.com/ QAD/B141) and papular culture was positive for P. marneffei (Fig. S1C, http://links.lww.com/QAD/ B141). Lumbar puncture revealed cerebrospinal fluid (CSF) opening pressure of 330 mmH2O and CSF India ink stain for C. neoformans was positive (Fig. S1D, http://links.lww.com/QAD/B141). CSF culture grew C. neoformans and urease test for C. neoformans was positive.