An 18-month-old boy presented with a fever and a widespread presumably itchy eruption. He was a recent immigrant from Nigeria, and was brought for care by a maternal aunt. Both of his parents remained in Nigeria, ill with AIDS.
Key point: The patient was observed vigorously scratching at rash-filled areas, thereby establishing that the eruption was pruritic. There were enlarged cervical, axillary, and inguinal lymph nodes. Considering the family history, tests for HIV infection were obtained and found to be positive. CD4 cell counts were severely depressed.
Treatment: The patient was referred to a specialty HIV clinic for therapy.
Note: This nonspecific pruritic eruption is a common manifestation associated with HIV infection, especially in the pediatric population. HIV/AIDS should be considered in the differential diagnosis when such an eruption presents, particularly if the patient has emigrated from an area in which the infection is highly endemic.