When the Gut Speaks First: A Case of HIV Diagnosed through Gastrointestinal Opportunistic Infection

Abstract

Background: The gastrointestinal (GI) tract is a frequent site of clinical manifestations in HIV-infected individuals due to its direct contact with the external environment and susceptibility to opportunistic infections (OIs).

Case History: A 44-year-old male presented to the Emergency Department with dyspepsia, odynophagia and weight loss. His medical history included psoriasis, chronic obstructive pulmonary disease, past cerebral hemorrhage, smoking. Initial examinations were unremarkable, except for mild lymphopenia. Imaging revealed oesophageal mucosal thickening and lymphadenopathy, while upper GI endoscopy showed ulcerative oesophagitis and reduced gastric wall distensibility. An infectious etiology was suspected. Further investigation revealed HIV infection, so the patient was transferred to the Infectious Diseases Unit for HAART (Highly Active Antiretroviral Therapy) administration.