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Martin is 52 years old and known to have HIV. He admits poor compliance with his antiretroviral medications and cannot recall the last time he attended a clinic appointment. He attends today with a 5 day history of night sweats, diarrhoea and fever. You liaise with the HIV clinic and establish his CD4 count 4 months ago was 45/mm3. You consider Mycobacterium avium complex as a differential.

Which of the following clinical features would not be in-keeping with this?

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