This case report follows a previously asymptomatic man who presented with common, non-specifi c symptoms and was diagnosed with a rare complication of non-typhi Salmonella infection. Further investigations revealed the presence of advanced HIV infection and with subsequent follow up a number of co-existing pathologies were diagnosed with fatal consequences. This case serves as an example of the complexity of patients diagnosed with late HIV disease. It serves as a clear reminder to all clinicians to have a low threshold for testing for HIV and highlights the need to introduce an opt-out system for HIV testing in all acute healthcare settings with a high prevalence of HIV infection.