A 3-year-old girl is admitted to the hospital with fever, fatigue, and a rash that developed during the past 24 hours. The rash initially appeared on the trunk but subsequently spread outward to the face and extremities. She is a recent international adoptee and arrived at her new home 2 days before her presentation to the hospital. This is her first visit to a physician since arriving in the United States. She lived in an orphanage in a city on India’s west coast for approximately 1 year before her adoption. She has human immunodeficiency virus (HIV) infection acquired via mother-to-child transmission; her most recent CD4+ count, obtained 1 year before her arrival, was 2,210/μL (2,210 × 106/L; reference range, 900–2,860/μL [900–2,860 × 106/L]). She began antiretroviral therapy approximately 10 months before her adoption, and her current regimen consists of zidovudine, lamivudine, and nevirapine (NVP). She...

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