Connolly SP, McGrath J, Sui J, Muldoon EG. Rare, disseminated Kaposi sarcoma in advanced HIV with high-burden pulmonary and skeletal involvement.
BMJ Case Rep 2021;
14:14/12/e245448. [PMID:
34853045 PMCID:
PMC8638125 DOI:
10.1136/bcr-2021-245448]
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Abstract
We describe the case of a 30-year-old man who presented to our institution with hypoxia and widespread pulmonary infiltrates managed initially as COVID-19 before receiving a new diagnosis of HIV-associated Kaposi sarcoma (KS) with widespread pulmonary and skeletal involvement. Initial differential diagnoses included Pneumocystis jirovecii pneumonia, disseminated mycobacterial infection and bacillary angiomatosis. A bone marrow biopsy showed heavy infiltration by spindle cells, staining strongly positive for human herpes virus-8 (HHV-8) and CD34, suggesting symptomatic, disseminated KS as the unifying diagnosis. The patient commenced cytotoxic therapy with weekly paclitaxel, with a clinical and radiological response. To our knowledge, this case is among the most severe described in the literature, which we discuss, along with how COVID-19 initially hindered developing a therapeutic allegiance with the patient.
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