A 50-year-old black man with newly diagnosed HIV/AIDS, genital herpes, and latent syphilis presented with a nonproductive cough. The patient received a diagnosis of HIV and started highly active antiretroviral therapy (HAART) with emtricitabine/tenofovir disoproxil fumarate, darunavir, and ritonavir 2 months prior to presentation. CD4+ count was 1/μL and viral load was 538,884 copies/mL prior to initiation of HAART. The patient endorsed compliance with all medications since diagnosis. The patient had a persistent, dry cough at time of HIV diagnosis that had acutely worsened during the 2 weeks leading to admission. He denied fevers, chills, hemoptysis, or dyspnea but did endorse drenching night sweats.