A 55-year-old man presented with a chronic cheek ulcer that had appeared two months ago. Cephalexin, followed by amoxicillin/clavulanate and then moxifloxacin, did not resolve the issue. The patient has a medical history of hypertension. Physical examination Vital signs: Temperature,:99.4°F; pulse: 80 beats/min; respiratory rate: 16 breaths/min; blood pressure: 130/80 mm Hg General: Non-ill-appearing HEENT: Nickel-sized ulcer on the cheek, slightly raised edges, nonpainful Lungs: Normal Heart: Normal Abdomen: Normal Extremities/skin: Normal Diagnostic evaluation WBC count: 9200 cells/µL Hemoglobin level: 11.2 g/dL Differential: 8% lymphocytes; 2% monocytes; 90% polymorphonucleocytes Culture: Cryptococcus gattii Biopsy: Yeast forms and granuloma Serum cryptococcal antigen: Negative HIV: Negative CD4 count: 186 cells/µL What is this patient suffering from?
A. HIV B. Idiopathic low CD4…
