Learning together HIV– Initial presentation

Dr Khloud Adam SHO and Karl Fuchs FY1 Abstract 34yearold female with no past medical history presented to ED with complaint of 3 weeks history of indigestion of solid foods associated with epigastric pain and vomiting and a positive history of 6kg weight loss over 3 weeks On further enquiry of the social history the patient reported working as a health care assistant and has recently migrated to the UK from Namibia Initial systemic examination was unremarkable Bloods tests showed elevated ALP table 1 and multiple nodular opacities throughout the lungs on Xray Figure 1 On further consultation HIV test was done which came back positive a differential not thought of by the initial clerking doctor Patient stated a HIV test done 3 years prior to this presentation was negative OGD described severe oesophageal candidiasis and CT body reported multiple chest nodules thickened gall bladder dilated intrahepatic duct hepatomegaly and prominent lymph nodes

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