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October 16, 1987

AIDS Wrongly Diagnosed

Author Affiliations

The Johns Hopkins Hospital Baltimore

The Johns Hopkins Hospital Baltimore

JAMA. 1987;258(15):2063-2064. doi:10.1001/jama.1987.03400150055020

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To the Editor.—  The significance of a diagnosis of acquired immunodeficiency syndrome (AIDS) is widely appreciated and includes a grave prognosis as well as problems with medical expenses, employment, housing, and interpersonal relationships. Diagnosis of some AIDSdefining conditions requires considerable technical expertise. We report a case of misdiagnosis.

Report of a Case.—  A 58-year-old black man was admitted to a community hospital in July 1986 for dyspnea and mild nonproductive cough. He had used intravenous drugs (heroin and cocaine) for the prior 18 years. Physical examination revealed a large man in minimal distress; there were bibasilar rales, and multiple scars at sites of prior drug injection. His oral temperature was 37.6°C. The white blood cell count was 4.7×109/L (4700/mm3), with 0.30 (30%) lymphocytes; hemoglobin level was 119 g/L (11.9 g/dL). A chest roentgenogram demonstrated bilateral basal interstitial infiltrates; arterial oxygen partial pressure was 48 mm Hg. On