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Pain in HIV: An Evolving Epidemic

      JG was a 46-year-old man with acquired immune deficiency syndrome (AIDS) proven to be refractory to antiretroviral therapy. He presented to the emergency room with severe oral pain and odynophagia developing over 2 weeks, limiting his nutritional intake significantly with 10 pounds of weight loss. Additional medical history was significant for seizures and a cerebrovascular accident (CVA) 4 years prior. On review of systems, he denied fevers, diarrhea, or skin lesions; however, he reported several months of painful tingling in both feet that was worsened when wearing socks and shoes. Medications on admission included sulfamethoxazole-trimethoprim, valacyclovir, azithromycin, fluconazole, as well as several antiretroviral agents.

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