ABSTRACT
A 35-year-old man was admitted from the emergency department with a 48-hour history of a rash over his face and trunk, in addition to fevers and diarrhoea. Four weeks earlier, he had been diagnosed with HIV during a routine sexual health screen and had commenced co-trimoxazole for Pneumocystis jirovecii pneumonia (PCP) prophylaxis. At that time, the p24 antigen test was negative, indicating that HIV seroconversion had not occurred within recent weeks. He subsequently attended the emergency department 2 weeks later, where he complained of fevers and malaise. His urine dip had been positive for leucocytes and he commenced a 7-day course of oral co-amoxiclav for a presumed urinary tract infection (urine culture later showed no growth). His general practitioner had also prescribed a course of flucloxacillin when the rash had first developed 2 days earlier. He had no other past medical history and took no other medications. He worked as a pharmacist and lived with his partner. He had travelled to Florida in the past 2 months, did not drink alcohol and had never smoked.
