{"ops":[{"insert":"A 45-year-old man presents with multiple lumps over his face and neck for 3 months. The lumps are small, painless, and non-tender. Close questioning reveals intermittent low-grade fever, a non-productive cough, anorexia, and a loss of 10 kg of weight, all over the last half-year.\n \nHis medical and surgical histories are unremarkable, and he is not on any medications. He does not smoke, but drinks around 7 to 10 units of alcohol per week. He has had unprotected sexual intercourse with multiple women over the past two decades. He has never engaged in intravenous (IV) drug abuse.\n \nHe unmarried, a Thai citizen, and lives and works in Bangkok. He is currently visiting his brother, who persuaded him to seek medical attention for his complaints.\n \nA complete blood count shows a hemoglobin of 10.5 g\/dL (normal: 11-18), WBC of 3,500\/mm3 (normal: 4,600-11,000), and platelet count of 180,000\/mm3 (normal: 150,000-450,000). Plain x-rays of the chest reveal diffuse reticular infiltrates bilaterally. A renal profile, liver profile, random plasma glucose, and HbA1c are all within normal parameters.\n \nScreening for HIV is positive; follow-up testing with a western blot assay is also positive.\n"},{"insert":"\n"},{"insert":{"image":"\/storage\/case-images\/pd\/PD-M-271_en.png"}},{"insert":"\n"}]}
{"ops":[{"insert":"Following staining of the biopsy specimen with silver methenamine, microscopy reveals multiple non-budding yeast cells with a transverse septum.\n \nSamples are sent for culture; these are positive for Talaromyces marneffei.\n"}]}
