Global Grand Rounds in Infectious Diseases (2018-07-25)

A 54 year old male, farmer and resident of Pune with PLHIV for 2 years and not on treatment and no CD4 done presents with:

• 
  Loose motions, 4-5 times per day, watery, not associated with mucus or blood
• 
  Non foul smelling since 3 months
• 
  Pain in abdomen in right lumbar region since 2 months
• 
  Swelling over right lumbar region since 10 days

Systemic Examination:

PA: Soft, no hepatosplenomegaly Hard, tender lump of 8 x 10 cm in right lumbar region, mobile, No sign of inflammation

CVS: S1,S2 + No murmur

RS: BSBE clear

CNS: No focal neurological deficit