Acid-fast bacilli with cytomegalovirus and herpesvirus inclusions in the skin of an AIDS patient.

A 66-year old acquired immunodeficiency syndrome (AIDS) patient presented with cutaneous lesions suspicious for Kaposi's sarcoma. Biopsies disclosed granulomatous infiltrates with acid-fast bacilli and cytomegalovirus inclusions within macrophages and endothelial cells in one biopsy. Herpesvirus vesicle, necrotizing folliculitis, and vasculitis were observed in a second biopsy taken concurrently. These findings emphasize the polymorphous presentation of infectious disorders in AIDS and the need for multiple biopsies and for work-up with special stains in these patients.