{"ops":[{"insert":"A 33 year old HIV positive man presents with lower abdominal discomfort, alternating diarrhea and constipation, rectal bleeding with a mucopurulent discharge, and tenesmus for 2 weeks.\n\nHe engages in regular anal intercourse with his male partner.\n\nHe is currently on highly active antiretroviral therapy (HAART). His CD4 count is 1158 cells\/mm3, while the HIV viral load is \u003C50 copies\/mL.\n"},{"insert":"\n"},{"insert":{"image":"\/storage\/case-images\/pd\/PD-M-210_en.png"}},{"insert":"\n"}]}
2
Investigate
Lower GI Endoscopy
{"ops":[{"insert":"The rectum and sigmoid colon are inflamed. Multiple rectal ulcers are present.\nBiopsy of an ulcer shows acute and chronic inflammatory cells, with a lymphoid infiltrate.\n"}]}
Stool Microscopy & Culture
{"ops":[{"insert":"No amoeba, ova or parasites are noted.\nCultures are negative.\n"}]}