A 30-year-old female with a body weight of 47 kg was confirmed to be HIV seropositive shortly after her husband was diagnosed with HIV infection by the blood bank service. On clinical examination, the woman was pale, emaciated, with bad oral cavity hygiene, while a purple coloured mass (resembling Kaposi sarcoma) was identified in the oral cavity (on the right upper jaw extending to the inside of occupying the gingiva and part of the hard palate) (Figure 1). Small (< 0.4 cm) cervical and submandibular lymph nodes were found. Examination of the abdomen revealed a - just palpable below the respective hypochondrium- enlargement of the liver and spleen.

Laboratory examinations revealed pancytopenia (white blood cell count 1.60 x 103/ìL, neutrophils 59.4%, lymphocytes 29.1%, monocytes 11.5%, red blood cell count 2.9 x 106/ìL, hemoglobin 8.4 g/dL, hematocrit 26.2%, and platelet 63 x 103/ìL), elevated lactic dehydrogenase 593 IU/L (normal range 225-450) and elevated gamma globulins 32.7% (normal range 11-22%). Electrolytes, liver function tests, creatinine, and urea were within normal limits. Her CD4 were 102 cells/ìl and HIV viral load 30,764 copies/ml. The patient was further investigated with CT scans of the chest, abdomen, and pelvis that did not show any abnormal findings. Highly active antiretroviral therapy (HAART) with zidovudine, lamivudine, and effavirenz as well as primary prophylaxis for opportunistic infections with atovaquone (she was allergic to cotrimoxazole) and azithromycin was initiated.