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A 59 year old female  patient with AIDS with a CD 4 count of 147 from the Mississippi River valleys. Presents with fever, worsening cough, weight loss, malaise, and dyspnea. The patient also had symptoms of diarrhea and abdominal pain.

Physical examination reveals dilatation of collaterals in the neck and thorax  and edema of the face, neck, and upper torso and conjunctiva.

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