Case Report

A 26-year-old African American male with a history of HIVand CD4 count of 507 on HAART was sent to the Emergency Department after a biopsy of a psoas muscle collection demonstrated pustular drainage. The patient reported that approximately three weeks prior to presentation he was found to have elevated liver function tests on routine labs at his primary care office. Subsequently, the patient was sent for an abdominal ultrasound and CAT scan which showed a confluence of lymphnode surrounding the porta hepatis as well as a psoas muscle collection. In review of systems, he reported chronic left-sidedweakness and occasional muscle tightness in both legs. He denied weakness on the right side, as well as, fevers, chills, coughor shortness of breath. The physical exams was unremarkable except for 4/5 weakness in the left lower extremity. Radiographicimaging (Figure 1) revealed fluid collection in the psoas muscle and abscesses in the liver and spleen.