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March 1996

Palpable Purpura in an HIV-Positive Patient

Arch Dermatol. 1996;132(3):341-342. doi:10.1001/archderm.1996.03890270117018

REPORT OF A CASE  A 30-year-old black man with a 2-year history of an asymptomatic human immunodeficiency virus (HIV) infection Presented to his local physician with a 1-week history of a sore in his mouth. He was treated with ciprofloxacin. Progressive shortness of breath and a nonpruritic rash developed.Several days later, on presenting to an outlying emergency department he was noted to be tachypnic, tachycardic, and febrile (38.9°C). Arterial blood gas tests showed the following: pH, 7.47; Pco2, 13 mm Hg; and PaCO2, 65 mm Hg (room air). He was transferred to our emergency department, where he had a respiratory rate of 28 breaths per minute and a pulse of 120 beats per minute. His temperature was 37.6°C. He was a thin, illappearing man with dry oral mucosal surfaces but no oral ulcerations. His liver and spleen were enlarged. Prominent, palpable purpuric lesions were present on his