The FP diagnosed the boy with herpes zoster that was found in multiple dermatomes. He did not think it was disseminated because it was still localized to one area and there were not 20 or more lesions outside the primary zoster. However, the FP was very concerned about HIV and the boy was tested. A rapid HIV test came back positive.
The FP discussed the results of his findings with the child's grandmother, who was now caring for the child. An attempt was made to obtain oral or intravenous acyclovir but it was not available in the village or local health center. The child was given oral liquid acetaminophen for the pain and was added to the list for the local HIV clinic. Fortunately, the zoster resolved without antiviral medications and the child began to receive care for his HIV infection.
Photos and text for Photo Rounds Friday courtesy of Richard P. Usatine, MD. This case was adapted from: Mayeaux EJ, Usatine R. Zoster. In: Usatine R, Smith M, Mayeaux EJ, et al, eds. Color Atlas of Family Medicine. 2nd ed. New York, NY: McGraw-Hill; 2013:712-717.
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