Atypical Acute Retroviral Syndrome Presenting as a Facial Palsy

Abstract

Acute retroviral syndrome (ARS) refers to signs and symptoms present during acute human immunodeficiency virus (HIV) infection. Historically, ARS has been characterized as a mononucleosis-like illness. However, ARS may present with typical (i.e., mononucleosis-like) or atypical signs and symptoms. Here, we review typical and atypical ARS and discuss a 30-year-old man who first presented with a facial palsy and returned 2 years later with oral hairy leukoplakia, at which time he was found to have HIV and acquired immunodeficiency syndrome (AIDS). We suggest that facial palsies should pique clinical suspicion for HIV, especially in the context of recent or concurrent flu- or mononucleosis-like illness.