I know this is a hard picture to see but we're looking at that nodular red-purple skin lesion in this gentleman. He presented to his primary care physician complaining of fever, chills, malaise, headache, anorexia, and weight loss. Concerned about these constitutional symptoms, the primary care doctor sent off a bunch of labs and found that the patient was HIV positive with CD4 count 95 cells/mm3. He was then referred to you for this odd skin lesion.
These lesions typically first develop as small red to purple papules that can expand to large pedunculated lesions or nodules that may be friable. Though the surface starts off smooth, it can erode and ulcerate. Trauma may cause lesions to bleed profusely. This is the only lesion noted on this gentleman.
Challenge: Well, you think, this is probably Kaposi's sarcoma, until the primary care doctor calls you and says the blood cultures came back positive with what organism? (Meow)
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