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Arbune M, Padurariu-Covit MD, Tiutiuca C, Mihailov R, Niculet E, Arbune AA, Tatu AL. Unusual Localization of AIDS-Related Kaposi's Sarcoma in a Heterosexual Male during the COVID-19 Pandemic: A Case Report. Trop Med Infect Dis 2024; 9:47. [PMID: 38393136 PMCID: PMC10892696 DOI: 10.3390/tropicalmed9020047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 02/10/2024] [Accepted: 02/12/2024] [Indexed: 02/25/2024] Open
Abstract
Kaposi's sarcoma is an AIDS-defining illness and remains the most frequent tumor arising in HIV-infected patients with multifactorial etiology. We present a case of a 30-year-old Caucasian male with an 18-year history of HIV infection. The patient was presented with a one-week history of fever, non-productive cough, and skin lesions. There was an associated weakness and weight loss in a duration of 6 months. Clinical examination showed fever, generalized lymphadenopathy, lower limb edema, ascites, and violaceous cutaneous eruption comprising patches, plaques, and nodules. He also had a red nodule on the left conjunctiva, as well as on his oral mucosa. His CD4+ count was below 10/mm3 and ARN-HIV viral load was above 100,000 c/mL, in relation to the antiretroviral failure after five drug regimens. The role of co-infections in oncogenesis and the course of Kaposi's sarcoma were considered in recent studies. Delayed diagnosis of Kaposi's sarcoma in the present case resulted in a negative impact for this patient during the COVID-19 pandemic.
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Affiliation(s)
- Manuela Arbune
- Medical Clinic Department, Dunarea de Jos University, 800008 Galati, Romania; (M.A.); (A.-L.T.)
- Clinical Hospital for Infectious Diseases, 800179 Galati, Romania
| | - Monica-Daniela Padurariu-Covit
- Doctoral School of Biomedical Sciences, Dunarea de Jos University, 800008 Galati, Romania
- Hematology Department, Sf. Apostol Andrei Emergency County Hospital, 800578 Galati, Romania
| | - Carmen Tiutiuca
- Surgery Clinic Department, Dunarea de Jos University, 800578 Galati, Romania; (C.T.); (R.M.)
- Ophthalmology Department, Sf. Apostol Andrei Emergency County Hospital, 800008 Galati, Romania
| | - Raul Mihailov
- Surgery Clinic Department, Dunarea de Jos University, 800578 Galati, Romania; (C.T.); (R.M.)
- General Surgery Department, Sf. Apostol Andrei Emergency County Hospital, 800578 Galati, Romania
| | - Elena Niculet
- Morphological and Functional Sciences Department, Dunarea de Jos University, 800008 Galati, Romania;
- Pathology Department, Sf. Apostol Andrei Emergency County Hospital, 800578 Galati, Romania
- Multidisciplinary Integrated Center for Dermatological Interface Research, 800010 Galati, Romania;
| | - Anca-Adriana Arbune
- Multidisciplinary Integrated Center for Dermatological Interface Research, 800010 Galati, Romania;
- Neurology Department, Fundeni Clinical Institute, 077086 Bucharest, Romania
| | - Alin-Laurentiu Tatu
- Medical Clinic Department, Dunarea de Jos University, 800008 Galati, Romania; (M.A.); (A.-L.T.)
- Clinical Hospital for Infectious Diseases, 800179 Galati, Romania
- Multidisciplinary Integrated Center for Dermatological Interface Research, 800010 Galati, Romania;
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Pulmonary Kaposi Sarcoma without Respiratory Symptoms and Skin Lesions in an HIV-Naïve Patient: A Case Report and Literature Review. Infect Dis Rep 2022; 14:228-242. [PMID: 35447880 PMCID: PMC9025598 DOI: 10.3390/idr14020028] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 03/21/2022] [Accepted: 03/23/2022] [Indexed: 02/05/2023] Open
Abstract
Kaposi sarcoma (KS) is a multifocal lympho-angioproliferative, mesenchymal low-grade tumor associated with a γ2-herpesvirus, named Kaposi sarcoma-associated virus or human herpesvirus (KSHV/HHV8). The lung is considered a usual anatomical location of KS, despite being infrequent, often in association with extensive mucocutaneous lesions and very uncommonly as an isolated event. We report a case of a pulmonary KS (pKS) in a human immunodeficiency virus (HIV) naïve patient, which was atypical due to a lack of cutaneous involvement and an absence of respiratory symptoms. The pKS was initially identified as a tumoral suspected nodular lesion and only after immunohistochemical analysis was it characterized as KS. Furthermore, the diagnosis of pKS led to the discovery of the HIV-seropositive status of the patient, previously unknown. Our report underlines the importance of considering pKS even without skin lesions and as a first manifestation of HIV infection. We also reviewed literature on the current knowledge about pKS in people living with HIV (PLWH) to underline how one of the most common HIV/acquired immunodeficiency syndrome (AIDS) associated tumors can have a challenging localization and be difficult to recognize.
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