LAUSR

A 45-year-old male with a history of human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) presented with a diffuse, tender, nodular rash along with fevers, chills, nausea, vomiting, and tachycardia. The patient reported nonadherence to his antiretroviral therapy (ART) for the last 2 years. He was diagnosed with HIV 20 years ago, and his most recent CD4 count 9 months prior to presentation was 493. While off ART in the past, his CD4 count had decreased to 29. On admission, CD4 count was 77, and HIV viral load was 16,498 copies/ml. Physical examination revealed multiple scattered 1–2 cm subcutaneous nodules on his bilateral upper and lower extremities (Fig. 1a). Bacterial culture of a fluctuant nodule on his right arm grew methicillin-sensitive Staphylococcus aureus (MSSA). Punch biopsy of a subcutaneous nodule on his left arm was performed for histopathologic evaluation and tissue cultures (Fig. 1b–d). A. Kaposi sarcoma (KS) B. Cutaneous cytomegalovirus (CMV) infection C. Cutaneous Mycobacterium avium complex (MAC) D. Disseminated blastomycosis cutaneous infection (a) (b)