A case report of the rapid dissemination of Kaposi’s sarcoma in a patient with HIV

Abstract

Introduction: Kaposi’s sarcoma is the most common HIV-associated neoplastic disease. In most cases it starts on the skin and later spreads to other visceral organs. We reported a case of HIV-associated cutaneous Kaposi’s sarcoma which rapidly progressed to involve the visceral organs within a few weeks and resulted in fatality. Case presentation: A 21-year old man who recently started antiretroviral therapy developed disseminated Kaposi’s sarcoma with a right-sided pleural effusion. Chest x-ray confirmed the effusion which was tapped for diagnostic purposes. Biopsy confirmed Kaposi’s sarcoma. He insisted on being discharged so that he could visit a traditional healer. Management and outcome: Despite antiretroviral therapy and supportive management his condition deteriorated rapidly and he died within a month of the diagnosis of disseminated Kaposi’s sarcoma. He died before chemotherapy could be commenced. Discussion: The lessons that could be learned from this case include the following: Kaposi’s sarcoma is asymptomatic and, since one out of three are HHV-8 positive, patients should have a thorough examination before starting on highly-active antiretroviral therapy. Patients with Kaposi’s sarcoma or even those on treatment should be warned of deterioration in the first 12 weeks of treatment. Pulmonary Kaposi’s sarcoma is fatal and requires timeous management and chemotherapy. Patients with HIV-related Kaposi’s sarcoma and chest signs require sputa to exclude pulmonary tuberculosis. Finally, traditional healers may be used to assist, especially if they are taught to identify HIV-related skin conditions and can refer patients appropriately.

Keywords

• Kaposis sarcoma, dissemination, rapid progression, HIV/AIDS