A 45-year-old male with a history of human immunodeficiency virus, (HIV), on highly active antiretroviral therapy (HAART), Kaposi’s sarcoma, and squamous cell carcinoma (SCC) of the right lower extremity complicated by chronic wound formation presented with worsening right leg pain and increasing wound drainage.

The patient described the pain as excruciating, with 10/10 intensity and exacerbated by movement. His wounds began draining purulent material and blood about two weeks prior to presentation. He has had several similar, though milder episodes in the past requiring hospitalization. When the wounds began to have a foul odor, he presented to the hospital. On review of systems, the patient reported new-onset back pain that began approximately one week prior to admission. The pain was constant, sharp, worse with movement, and had an insidious onset. He also had a recent 30 lb weight loss with worsening fatigue. He denied fevers and chills.