Bsline:Male, prev healthy; WBC ~4.5, TLC 1.6–2.1, CRP 0.2, ESR <10

Day 6:ARS-like (sore throat, fatigue), new inverse psoriasis rash

Post-ARS Day 10:Severe GI dysbiosis after recent abx + probiotics

:WBC 5.7, TLC 1.22; relief after stopping probiotics

Wk 4:WBC 5.3, TLC 1.9; HIV/STD neg

Wks 5–7:HIV Ag/Ab + RNA/DNA PCR neg; CD4 432(32%), CD8 443, ratio 0.97; ang cheilitis, severe balanitis, seborrheic dermatitis, reactive submental LN in US; CRP 0.5, ESR 8

Wk 9:EBV/CMV neg; CD4 421(36%), CD8 355, ratio 1.12; TLC 1.1; Ig normal

Wk 12.5:HIV neg; worsening GI/skin fungal+staph disease, ; fluconazole → GI relief, constipation returns; LN shrinks; SIBO neg; WBC 4.5, TLC 1.45; stool/CMP/O&P neg

Wk 14:Linzess started; cheilitis resolves; ESR 18, LN bigger

Wk 15:CT/MRCP/MRI: mild focal intrahepatic ductal dilatation (R lobe)

Wk 16:Post-meal pain,tired (Candida); add avocado oil ->improves bile flow, motility,energy, 

Q: Novel HIV-like retrovirus vs bile-tropic pathogen? blood mNGS? please help