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A 28-year-old HIV-positive male complains of pain on swallowing. Physical examination is remarkable for white plaque-like material on his tongue and buccal mucosa, which is scraped and sent to the laboratory. Based on these findings, and on the laboratory results , the man is diagnosed with acquired immunodeficiency syndrome (AIDS).

With which of the following agents is the man most likely infected?

A. Candida albicans
B. Cytomegalovirus
C. Herpes simplex I
D. Human herpesvirus 8
E. Human papilloma virus


direct forword candida albecans sticking out tongue


I wish such Qs appear on MLE grin


yes really easy-->A




The correct answer is A.

Candida albicans produces oral thrush, an AIDS-defining lesion, which is common in acute HIV disease, and becomes increasing common as the CD4 + cell count falls. The lesions are usually painless. Diagnosis is by demonstration of pseudohyphae using a wet smear with confirmation by culture.

Although cytomegalovirus (choice B) is associated with numerous clinical scenarios in the AIDS population, including odynophagia (painful swallowing), it would not produce white plaques on the oral mucosa.

Herpes Simplex I (choice C) produces vesicular lesions occurring in clusters in the oral cavity. There is an increased risk of herpes infections in the AIDS group, but the lesions do not resemble those described in the question.

Human herpesvirus 8 (choice D) is the causative agent of Kaposi's sarcoma, a malignancy arising from endothelial cells that appears as hemorrhagic nodules in different organ systems. It is the most common cancer in the HIV infected population.

Human papilloma virus (choice E) is associated with a variety of lesions, including warts and intraepithelial neoplasias of the vulva and cervix. It is associated with anal condyloma, which can occur in the AIDS population.

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