Last updated on: February 21st, 2021

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A 41 year old man presents with diffuse abdominal pain, generalized myalgia, and dark urine for 2 days. He did not experience dysuria, frequency or urgency.

There is no history of recent trauma, NSAID use, recreational drug abuse, or travel to a foreign country.

His medical history is significant for HIV infection for 2 years, for which he is on ritonavir-boosted atazanavir, tenofovir and emtricitabine. He was tested in this regard 1 week ago, and found have a CD4 count of 450 cells/mm3 with consistent viral suppression.

He was also diagnosed with dyslipidemia 1 month ago, and after poor control with diet alone, started on simvastatin 20 mg daily.

He does not smoke and only drinks socially. A full blood count is found to be normal.

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