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Pulmonary Embolism an Uncommon First Presenting Symptom of an Undiagnosed Case of HIV Anil Jha1, Hassan Ghoz1, Nicholas James2 1Division of Internal Medicine, Steward Carney Hospital, Tufts School of Medicine, Dorchester, MA, USA 2Division of Critical Care and Pulmonology, Steward Carney Hospital, Tufts School of Medicine, Dorchester, MA, USA ABSTRACT A 32 years old male who presented to our emergency department with shortness of breath, cough and weight loss, all started less than a month time and later diagnosed with HIV infection with very high viral load and low CD4 count. His presenting history was lead the diagnostic workup toward malignancy as there was large hilar masses and concern of metastasis to different place mainly abdomen. Suspicion of HIV arouses as the biopsy from the hilar mass came back negative for malignancy but was positive for tuberculosis. HIV serology came back positive. The literature review showed pulmonary embolism as the very rare first presentation of HIV, and only four cases reported so far. Although venous thromboembolism is very common in chronic cases of HIV. J Microbiol Infect Dis 2018; 8(1):33-36 Keywords: HIV, pulmonary embolism, cough, chest pain, tuberculosis

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