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On September 16, 1991, a 31-year-old, heterosexual white man without risk factors for the acquired immunodeficiency syndrome was admitted with an influenza-like syndrome of fever, mouth sores, odynophagia, rectal pain and bleeding, and weakness. Laboratory tests revealed a white-cell count of 2300 per cubic millimeter, a platelet count of 52,000 per cubic millimeter, and a hematocrit of 49 percent. Colonoscopy showed diffuse edema, erythema, mucosal friability, and whitish plaque-like lesions in the rectum. Rectal biopsy
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