A 44-year- old man presented with dry cough, diffuse joint pain, fevers, and night sweats for one month and poor appetite and weight loss for three months. Physical examination showed hepatosplenomegaly. A chest computed tomogram (Panel A and B) showed diffuse miliary nodules. Sputum for acid fast bacilli was negative. Testing for HIV-1 was positive with a high viral load and a low CD4 count of 4/µL. Bronchoscopy with bronchoalveolar lavage was performed. Gomori methenamine-silver stain of the bronchoalveolar lavage specimen showed intracellular yeasts within macrophages with narrow-based budding (Panel C).
