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Case 1: Herpes Simplex Virus Infection

You answered:

C The diagnosis of chronic (longer than 4 weeks) ulcerative herpes simplex is an AIDS-defining condition, regardless of CD4 cell count.

This answer is correct, but another answer is also correct. The Centers for Disease Control's case definition for Stage 3 (AIDS) includes HSV chronic ulcer(s) greater than 1 month's duration, regardless of the patient's CD4 cell count.

A When performing a fluorescent antibody (FA) and culture for HSV, scraping the base of the lesion will provide a higher yield than obtaining exudative fluid.
B The most appropriate therapy for this lesion would be valganciclovir (Valcyte) 900 mg PO bid x 4 weeks.
D Answers A and C are correct.

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