Man with painful tongue lesions

• Published in: Journal of the American College of Emergency Physicians Open 2022-12, Vol.3 (6), p.e12858-n/a
• Main Authors: Penny, Caitlin L., Koenig, Kristi L., Marty, Aileen M., Beÿ, Christian K., Norton, Valerie C.
• Format: Article
• Language: English
• Subjects: Antibodies; Blood; Coronaviruses; COVID-19; Disease transmission; Herpes viruses; HIV; Human immunodeficiency virus; Images in Emergency Medicine; Laboratories; Mpox; Polymerase chain reaction; Tongue
• ISSN: 2688-1152; 2688-1152
• DOI: 10.1002/emp2.12858

At presentation, his temperature was 39.3°C, pulse was 124 beats/min, respiratory rate was 20 breaths/min, blood pressure was 132/101 mmHg, and room air oxygen saturation was 100%. Painful tongue lesions at the time of emergency department presentation TABLE 1 Laboratory and imaging results Test Result Reference Range Units White blood cell count 7.2 3.4 - 11.0 K/mcL Hemoglobin 17.4 13.0 - 17.1 g/dL Platelets 172 150 - 425 K/mcL Sodium 133 137 - 145 mmol/L Potassium 4.1 3.5 - 5.1 mmol/L Chloride 95 98 - 107 mmol/L Bicarbonate 26 22 - 30 mmol/L Blood urea nitrogen 17 9 - 20 mg/dL Creatinine 1.00 0.70 - 1.30 mg/dL Calcium 8.6 8.4 - 10.2 mg/dL Glucose 105 70 - 125 mg/dL Magnesium 2.1 1.6 - 2.3 mg/dL Bilirubin, total 0.6 0.2 - 1.3 mg/dL Alkaline phosphatase 99 38 - 126 Units/L Alanine transaminase (ALT) 61 ≤ 49 Units/L Aspartate aminotransferase (AST) 58 17 - 59 Units/L Lactic acid, venous 2.6 0.70 - 2.10 mmol/L Absolute CD4+ 231 430 - 1800 cells/μL Absolute CD3 496 570 - 2400 cells/μL Treponemal antibody screen Reactive Non-Reactive Rapid plasma reagin (RPR) Positive (titer 1:8) Non-Reactive RPR, 38 months prior1 Positive (titer 1:2) Non-Reactive RPR, 45 months prior1 Positive (titer 1:2) Non-Reactive HIV viral load (PCR)