A 36-year-old man with a known history of HIV infection presents to the clinic with complaints of painful swallowing (odynophagia) and a burning sensation in his mouth for the past two weeks. He also reports white patches on his tongue and inner cheeks, which he had attempted to scrape off unsuccessfully. He denies fever, chills, nausea, or vomiting but mentioned a 10-pound unintentional weight loss over the past month and persistent fatigue. He is not currently on antiretroviral therapy (ART) and stated he has been lost to follow-up for two years. He reports occasional alcohol use but denies smoking or recreational drug use.His past medical history is significant for several infectious disorders. On examination, the patient appears thin but alert. Oral examination reveals extensive white, curd-like plaques on the tongue, buccal mucosa, and the palate, which are difficult to remove and leave an erythematous, bleeding surface. The rest of the physical examination is unremarkable, with no lymphadenopathy or organomegaly. Laboratory investigations show a CD4+ T-cell count of 45 cells/μL. His viral load is 500,000 copies/mL. A potassium hydroxide (KOH) preparation of the oral lesions reveals budding yeast and pseudohyphae. You wondered whether this current disorder is an AIDS-defining illness in this patient. Which of the following is an AIDS-defining illness?
