Spurious Presentation of Pulmonary Kaposi Sarcoma as Unresolved Pneumonia Led to Fatal Outcome

Acquired immunodeficiency syndrome (AIDS)-associated Kaposi sarcoma (KS) is an angioproliferative neoplasia caused by infection with human herpesvirus 8 (HHV-8). It typically presents with mucocutaneous involvement, but it can be disseminated. Initial presentation with primarily pulmonary KS is rare...

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Bibliographic Details
Published in:JIM - high impact case reports 2023-01, Vol.11, p.23247096231208996-23247096231208996
Main Authors: Mann, Baldeep Kaur, D’Assumpcao, Carlos, Okumoto, Lawrence, Aboaid, Shatha, Abooed, Ayham, Cobos, Everardo, Heidari, Arash
Format: Article
Language:English
Subjects:
Acquired immune deficiency syndrome
AIDS
Case Report
Chemotherapy
HIV
Human immunodeficiency virus
Immune system
Kaposis sarcoma
Pneumonia
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Summary:Acquired immunodeficiency syndrome (AIDS)-associated Kaposi sarcoma (KS) is an angioproliferative neoplasia caused by infection with human herpesvirus 8 (HHV-8). It typically presents with mucocutaneous involvement, but it can be disseminated. Initial presentation with primarily pulmonary KS is rare. We present a case of a 32-year-old male with untreated human immunodeficiency virus (HIV) diagnosed 1 year before presentation who developed progressively worsening cough and shortness of breath for 6 months. He was hospitalized twice and treated for unresolved pneumonia in an outside hospital. The patient concomitantly developed purplish nodules on his face, then the upper trunk, back, chest, and thighs bilaterally that gradually increased in size and number. Histopathology findings from skin lesions were consistent for KS. Bronchoscopy found multiple erythematous plaques throughout the tracheobronchial tree with telangiectasias and inflammation suggestive of pulmonary KS. His imaging findings and positive serum HHV-8 polymerase chain reaction (PCR) were consistent with disseminated KS. He started antiretroviral therapy (ART) to treat his HIV infection, followed by liposomal doxorubicin chemotherapy. But both ART and chemotherapy were interrupted due to adherence and insurance issues. The patient was readmitted with acute respiratory failure requiring mechanical ventilation with multiple vasopressors that led to the patient’s demise. The late recognition of KS diagnosis and delayed treatment can lead to worse outcomes.
ISSN:2324-7096
2324-7096
DOI:10.1177/23247096231208996