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em@3am

EM@3AM: Pancytopenia

A 36-year-old male with a history of HIV presents to the ED complaining of dyspnea on exertion and fatigue. He is not compliant with his anti-retroviral medications. His conjunctivae are pale. There is a painful ulcer to the distal aspect of the tongue and scattered petechiae on his legs. Laboratory evaluation reveals WBC 2,000/microL, Hgb 8.5 g/dL, and platelets 90,000/microL. What do the exam and lab findings suggest?