A 45-year-old Hispanic man who acquired HIV infection in April 2003 presented with a 24-hour history of worsening right lower quadrant pain accompanied by fever, decreased appetite, nausea, and vomiting. The pain was described as sharp, constant, and nonradiating. He denied any accompanying diarrhea, constipation, urinary frequency, dysuria, dyspepsia, reflux symptoms, or previous episodes of abdominal pain. There was no history of recent travel. His current CD4+ cell count was 239/?L. In May 2003, he had a CD4+ cell count nadir of 133/?L. His HIV RNA level has remained undetectable at less than 50 copies/mL since starting firstline antiretroviral therapy in June 2003. Therapy consists of coformulated zidovudine/lamivudine/abacavir and efavirenz. He has never had opportunistic infections or other major medical illnesses.