SHM Converge Scientific Abstract ePoster Gallery-A Tale of Two Viruses: Kaposi Sarcoma in an Unusual Location

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This case report describes a 36-year-old man with no known medical history who presented with two months of facial swelling, progressive dysphagia, oral candidiasis, and widespread painless purple skin nodules. Laboratory testing revealed microcytic anemia and thrombocytopenia. He was newly diagnosed with HIV, with a very high viral load and profound immunosuppression (CD4 count of 6 cells/mcL).<br /><br />Because of his facial edema and swallowing difficulty, a contrast CT scan of the neck was performed. It showed multinodular enhancing involvement of mucosal structures from the nasopharynx to the aryepiglottic folds, especially the epiglottis, along with additional nodules in the scalp and a left upper lobe lung lesion. These findings were suggestive of Kaposi sarcoma (KS). A punch biopsy of a skin lesion confirmed patch-stage Kaposi sarcoma.<br /><br />Kaposi sarcoma is a vascular neoplasm associated with human herpesvirus 8 (HHV-8) and is most commonly seen in patients with AIDS. It usually presents with cutaneous lesions, often on the lower extremities, face, oral mucosa, or genitalia. Laryngeal involvement is rare but can be dangerous because it may cause airway compromise. Although the appearance of KS can be highly suggestive, biopsy is needed for confirmation.<br /><br />The patient was evaluated by infectious disease and oncology specialists and started on antiretroviral therapy plus chemotherapy, which is the recommended treatment for advanced KS in HIV-positive patients. This case highlights that KS can be the first sign of undiagnosed HIV and that unusual sites such as the larynx should be considered when patients present with dysphagia or airway symptoms.

Asset Subtitle

Azfar A. Farooqi

Meta Tag

Author List Azfar A. Farooqi, Chen Rong Phang

Category Clinical Vignettes

Concept Kaposi Sarcoma

Concept Human Herpesvirus 8

Concept HIV Coinfection

Concept Biopsy

Concept HIV Therapy

Distinguished Non-Finalist

Presenter Organization Tidalhealth Peninsula Regional Medical Center

Presenting Author Azfar A. Farooqi

Track Adult

Keywords

Kaposi sarcoma

HIV/AIDS

CD4 count

dysphagia

facial swelling

laryngeal involvement

HHV-8

oral candidiasis

skin nodules

antiretroviral therapy

Kaposi Sarcoma

Human Herpesvirus 8

HIV Coinfection

Biopsy

HIV Therapy