The patient with human immunodeficiency virus (HIV) presents with a disseminated rash. The nurse notes purple papules over the trunk, arms, and on mucous membranes. Some are scabbed. The patient’s CD4 count is 64. Although highly active antiretroviral therapy (HAART) has been prescribed, the patient reports being noncompliant because of intolerable side effects. The nurse suspects which infection is most responsible for this new rash?

Question

The patient with human immunodeficiency virus (HIV) presents with a disseminated rash. The nurse notes purple papules over the trunk, arms, and on mucous membranes. Some are scabbed. The patient&rsquo;s CD4 count is 64. Although highly active antiretroviral therapy (HAART) has been prescribed, the patient reports being noncompliant because of intolerable side effects. The nurse suspects which infection is most responsible for this new rash?

Accepted Answer

Human herpes virus-8. The patient with acquired immunodeficiency syndrome (AIDS) due to human immunodeficiency virus is at risk for opportunistic infections when CD4 counts get low. This includes human herpes virus-8, which causes Kaposi sarcoma (purple papules). Varicella and Epstein-Barr viruses do not cause purple papules spread diffusely over the body with mucous membrane involvement. Although HIV predisposes the patient to HHV-8 infection and Kaposi sarcoma, other things that cause immunosuppression can also cause Kaposi sarcoma.

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