QuestionSBA
QuestionChoice
HIV seroconversion illness occurs when the body develops antibodies against the human immunodeficiency virus. This can result in the manifestation of a wide range of symptoms, including fever, sore throat, maculopapular rash, malaise, arthralgia, lymphadenopathy, and oro-genital ulceration. Due to the non-specific nature of the presentation, a high index of suspicion is required. Seroconversion typically occurs in the first few weeks after infection, however, can occur up to 6 months after initial exposure. HIV diagnosis can be confirmed with antibody and antigen testing and treatment should be initiated immediately regardless of CD4 cell count.
10000486
a
HIV seroconversion
QuestionChoice
Malaria is an important differential in individuals returning from endemic areas. However, it is an unlikely differential in this case. *Plasmodium falciparum* is the most common cause of malaria worldwide, and almost always presents within 3 months of exposure. Furthermore, although malaria can present with cutaneous symptoms, it would be very uncommon to present with a maculopapular rash.
10000489
d
Malaria
QuestionChoice
An important differential but unlikely in this patient's case. Although influenza is likely to present with fever, sore throat, and lymphadenopathy, influenza would be unlikely to present with a maculopapular rash. Furthermore, the history of sexual solicitation in a country of high HIV prevalence should further raise the index of suspicion.
10000488
c
Influenza
QuestionChoice
Gonococcal meningitis is a very rare complication of gonorrhoea infection which occurs when the infection becomes disseminated. However, this diagnosis is unlikely in this patient. This patient has presented without headache or nuchal rigidity, which are cardinal symptoms of meningitis. Therefore meningitis of any origin is unlikely in this patient.
10000487
b
Gonococcal meningitis
QuestionChoice
Dengue fever is a viral infection spread by the *Aedes aegypti* mosquito. Although an important differential, it is an unlikely diagnosis here due to timing. Dengue fever typically presents with fever, rash, headache, and sometimes severe myalgia and arthralgia. However, Dengue typically presents within 2 weeks of exposure and would not present in an individual after 4 months. Dengue fever is therefore an unlikely diagnosis.
10000490
e
Dengue fever
Concept
Chapter
2693
3774
Primary HIV infection
Topic
147
Infectious disease
12644
A 32-year-old male presents to the Emergency Department with a 3-day history of sore throat, fever, joint pain, and a new rash. On examination, you identify generalised lymphadenopathy and a maculopapular rash across his trunk. Further history reveals his only foreign travel recently was a trip to South Africa, where he admits he solicited sex work. This was, however, 4 months ago.

Which of the following is the most likely diagnosis?
a