PIMP #1

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So, following my gallant explanation of what the business of pimping implies in reference to medical schools here, it is finally, time to bring out the first pimp from the… wherever the pimps stay… and this is not that difficult a question, I just put it up because I enjoyed answering, and learning from this question!

A 24 year old man wit advanced HIV Infection, presented to the emergency department with a tan, painless nodule on his lower extremity which looked something like this:

 

#1.1 Tan, painless nodule on lower extremity

On examination, the patient was afebrile and did not show any such similar lesions anywhere else. He admitted that he was not on any kind of anti retroviral drugs. It was found that he had a CD4+ T-cell count of 20/microliter the last time he checked. He also admitted that he lived with his boyfriend who had a knack of keeping a lot of cats and kittens.

A biopsy was done and this was seen:

Biopsy under H&E

A tissue staining showed that the rod like structures were gram negative bacilli. Now for the question:

Skeptic Oslerphile, Scientist at the Indian Council of Medical Research, National Institute of Cholera and Enteric Diseases. Interests include: Emerging Infections, Public Health, Antimicrobial Resistance, One Health and Zoonoses, Diarrheal Diseases, Medical Education, Medical History, Open Access, Healthcare Social Media and Health2.0. Opinions are my own!

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