A horse in zebra stripes: A peculiar case of undetected end-stage AIDS

Kei Yoshimatsu, J. Michael Bostwick

Research output: Contribution to journalArticlepeer-review


Objective: Late HIV diagnosis occurs in up to 45% of new HIV cases in the developed world and is linked to worse health outcomes, including more hospitalizations, higher health care resource utilization and less robust responses to highly active antiretroviral therapy. Method: Case report. Results: A 70-year-old woman with an obscure constellation of medical and psychiatric complaints ultimately proved to have end-stage acquired immunodeficiency syndrome discovered much too late. Curiously, she had no obvious risk factors for HIV infection. Conclusion: This tragic case underscores the importance of keeping HIV infection in the differential for a patient with diverse vague complaints. Let this story caution its readers: when you hear hoof beats, do not look for zebras - even when you are least expecting a horse.

Original languageEnglish (US)
Article number7055
Pages (from-to)620.e3-620.e4
JournalGeneral Hospital Psychiatry
Issue number6
StatePublished - Nov 2015


  • AIDS
  • Depression
  • HIV
  • HIV-associated dementia
  • Mood disorder

ASJC Scopus subject areas

  • Psychiatry and Mental health


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