that appeared 1 week after he had milked cows with similar lesions on their udders. He had recently interrupted antiretroviral therapy after onset of depression because of his father's death 4 months before. Despite treatment with self-formulated antimicrobial drugs and home therapies (application of alcohol, methylene blue, and herbs), the lesions continued and spread within 1 month to his nostrils, glans penis, right leg, right knee, and ankles. On November 14, 2014, the patient was treated with antimicrobial drugs at a local hospital and instructed to comply with his antiretroviral therapy. On December 9, 2014, after failing to respond to treatment, the patient was referred to the Hospital Universitario Mayor Méderi in Bogotá, Colombia. Laboratory tests showed a CD4 cell count of 11 cells/mL and HIV viral loadthe ethical standards noted in the 1964 Declaration of Helsinki and its later amendments, and followed the national regulation contained in the 1993 resolution no. 008430 related to the ethical aspects of scientific research involving human beings where it is categorized as a minimal risk research. Samples were remitted to the Colombian National Institute of Health as part of the active virologic surveillance of potentially emerging threats.

Ms. Laiton-Donato is a researcher in the Sequencing and Genomic Unit, Virology Group, at the Instituto Nacional de Salud, Colombia. Her research is focused on molecular virology of emerging viruses. Dr. Ávila-Robayo is a medical doctor at Hospital Universitario Mayor Méderi, Colombia. Her work focuses on the care of patients with infectious diseases.
