SHM Converge Scientific Abstract ePoster Gallery-A Fatal Case of Kaposi's Sarcoma-Associated Herpesviris Hhv8 and Multicentric Castleman's Disease

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This case report describes a fatal episode of Kaposi sarcoma-associated herpesvirus (KSHV/HHV8)-associated multicentric Castleman disease (KSHV-MCD) in a 42-year-old man with newly diagnosed advanced HIV infection (CD4 79, viral load 1.35 million). KSHV-MCD is a rare but aggressive systemic inflammatory and lymphoproliferative disorder that primarily affects immunocompromised patients and often occurs alongside Kaposi sarcoma.<br /><br />The patient presented with weeks of worsening fatigue and poor oral intake, followed by fever, tachycardia, altered mental status, cachexia, and axillary lymphadenopathy. Laboratory findings showed profound anemia (hemoglobin 3.0), elevated inflammatory markers, polyclonal hypergammaglobulinemia, elevated IL-6, VEGF, and HHV8 PCR. Imaging revealed diffuse abdominal and axillary lymphadenopathy, and lymph node biopsy confirmed KSHV-MCD with concurrent Kaposi sarcoma.<br /><br />His hospital course was complicated by severe multiorgan dysfunction, including septic shock, respiratory failure requiring intubation, renal failure requiring continuous renal replacement therapy, fungemia, bacteremia, and high-grade AV block requiring pacing. Treatments included high-dose corticosteroids, antiretroviral therapy, atovaquone, ganciclovir, and rituximab, but his condition continued to deteriorate, and he was ultimately transitioned to comfort care after refractory multiorgan failure.<br /><br />The report emphasizes that KSHV-MCD typically presents with nonspecific constitutional symptoms such as fever, night sweats, fatigue, weight loss, rash, cough, abdominal pain, diarrhea, hepatosplenomegaly, anemia, and lymphadenopathy. Diagnosis requires a combination of imaging, biopsy, and HHV8 PCR. Early recognition is critical because prognosis is poor in advanced disease, especially when complicated by infection, organ failure, and associated malignancy.

Asset Subtitle

Fahema Nadira

Meta Tag

Author List Aesha Patel, Fahema Nadira, Krystina Woods

Category Clinical Vignettes

Concept KSHV-Associated Multicentric Castleman Disease

Concept Lymphadenopathy

Concept Interleukin-6

Concept Lymph Node Biopsy

Concept HIV Therapy

Distinguished Non-Finalist

Presenter Organization Mount Sinai Morningside/West Internal Medicine Program

Presenting Author Fahema Nadira

Track Adult

Keywords

Kaposi sarcoma-associated herpesvirus

KSHV-MCD

multicentric Castleman disease

advanced HIV infection

HHV8

Kaposi sarcoma

lymphadenopathy

multiorgan failure

rituximab

systemic inflammatory disorder

KSHV-Associated Multicentric Castleman Disease

Lymphadenopathy

Interleukin-6

Lymph Node Biopsy

HIV Therapy