Differential Diagnosis for Patient with HIV and Maculopapular Lesions
- Single Most Likely Diagnosis
- Disseminated Histoplasmosis: This diagnosis is likely due to the combination of maculopapular lesions, hemorrhagic plaques on oral mucosa, lymphadenopathy, and bilateral nodular infiltrates with hilar adenopathy on CXR, which are all consistent with disseminated histoplasmosis in an immunocompromised patient with HIV.
- Other Likely Diagnoses
- Disseminated Cytomegalovirus (CMV) Infection: CMV can cause a wide range of symptoms in immunocompromised patients, including skin lesions, oral ulcers, and pulmonary infiltrates.
- Disseminated Mycobacterium Avium Complex (MAC): MAC infection is common in patients with advanced HIV and can cause lymphadenopathy, skin lesions, and pulmonary infiltrates.
- Kaposi's Sarcoma: This is a type of cancer that can cause skin lesions, oral lesions, and lymphadenopathy in patients with HIV.
- Do Not Miss Diagnoses
- Pneumocystis Jirovecii Pneumonia (PCP): Although PCP typically presents with diffuse infiltrates on CXR, it can occasionally present with nodular infiltrates and is a life-threatening condition that requires prompt treatment.
- Tuberculosis (TB): TB can cause a wide range of symptoms, including skin lesions, oral ulcers, and pulmonary infiltrates, and is a significant concern in patients with HIV.
- Rare Diagnoses
- Penicilliosis: This is a rare fungal infection that can cause skin lesions, oral ulcers, and pulmonary infiltrates in immunocompromised patients.
- Cryptococcosis: This is a rare fungal infection that can cause skin lesions, oral ulcers, and pulmonary infiltrates in immunocompromised patients, although it is more commonly associated with central nervous system involvement.