Rare, disseminated Kaposi sarcoma in advanced HIV with high-burden pulmonary and skeletal involvement
We describe the case of a 30-year-old man who presented to our institution with hypoxia and widespread pulmonary infiltrates managed initially as COVID-19 before receiving a new diagnosis of HIV-associated Kaposi sarcoma (KS) with widespread pulmonary and skeletal involvement. Initial differential d...
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| Veröffentlicht in: | BMJ case reports 2021-12, Vol.14 (12), p.e245448 |
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| creator | Connolly, Stephen P McGrath, Jonathan Sui, Jane Muldoon, Eavan G |
| description | We describe the case of a 30-year-old man who presented to our institution with hypoxia and widespread pulmonary infiltrates managed initially as COVID-19 before receiving a new diagnosis of HIV-associated Kaposi sarcoma (KS) with widespread pulmonary and skeletal involvement. Initial differential diagnoses included
pneumonia, disseminated mycobacterial infection and bacillary angiomatosis. A bone marrow biopsy showed heavy infiltration by spindle cells, staining strongly positive for human herpes virus-8 (HHV-8) and CD34, suggesting symptomatic, disseminated KS as the unifying diagnosis. The patient commenced cytotoxic therapy with weekly paclitaxel, with a clinical and radiological response. To our knowledge, this case is among the most severe described in the literature, which we discuss, along with how COVID-19 initially hindered developing a therapeutic allegiance with the patient. |
| doi_str_mv | 10.1136/bcr-2021-245448 |
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pneumonia, disseminated mycobacterial infection and bacillary angiomatosis. A bone marrow biopsy showed heavy infiltration by spindle cells, staining strongly positive for human herpes virus-8 (HHV-8) and CD34, suggesting symptomatic, disseminated KS as the unifying diagnosis. The patient commenced cytotoxic therapy with weekly paclitaxel, with a clinical and radiological response. To our knowledge, this case is among the most severe described in the literature, which we discuss, along with how COVID-19 initially hindered developing a therapeutic allegiance with the patient.</description><identifier>ISSN: 1757-790X</identifier><identifier>EISSN: 1757-790X</identifier><identifier>DOI: 10.1136/bcr-2021-245448</identifier><identifier>PMID: 34853045</identifier><language>eng</language><publisher>England: BMJ Publishing Group LTD</publisher><subject>Adult ; Bacterial infections ; Biopsy ; Case Report ; Case reports ; Cell growth ; Chemotherapy ; Coronaviruses ; COVID-19 ; Cytomegalovirus ; Cytotoxicity ; Dyspnea ; Edema ; Herpesvirus 8, Human ; Histology ; HIV ; HIV Infections - complications ; HIV Infections - drug therapy ; Human immunodeficiency virus ; Humans ; Infections ; Infectious diseases ; Kaposis sarcoma ; Lungs ; Male ; Medical imaging ; Medical prognosis ; Sarcoma, Kaposi - diagnosis ; Sarcoma, Kaposi - drug therapy ; SARS-CoV-2 ; Severe acute respiratory syndrome coronavirus 2 ; Transplants & implants ; Tuberculosis ; Tumors</subject><ispartof>BMJ case reports, 2021-12, Vol.14 (12), p.e245448</ispartof><rights>BMJ Publishing Group Limited 2021. No commercial re-use. See rights and permissions. Published by BMJ.</rights><rights>This article is made freely available for use in accordance with BMJ’s website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained. https://bmj.com/coronavirus/usage?</rights><rights>BMJ Publishing Group Limited 2021. No commercial re-use. See rights and permissions. Published by BMJ. 2021</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c421t-19f036944dad871dee42c51a5031d45e38b903c469c40fbc77b9e9f073e0e9073</citedby><cites>FETCH-LOGICAL-c421t-19f036944dad871dee42c51a5031d45e38b903c469c40fbc77b9e9f073e0e9073</cites><orcidid>0000-0002-7814-1167</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8638125/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8638125/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,881,27901,27902,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34853045$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Connolly, Stephen P</creatorcontrib><creatorcontrib>McGrath, Jonathan</creatorcontrib><creatorcontrib>Sui, Jane</creatorcontrib><creatorcontrib>Muldoon, Eavan G</creatorcontrib><title>Rare, disseminated Kaposi sarcoma in advanced HIV with high-burden pulmonary and skeletal involvement</title><title>BMJ case reports</title><addtitle>BMJ Case Rep</addtitle><description>We describe the case of a 30-year-old man who presented to our institution with hypoxia and widespread pulmonary infiltrates managed initially as COVID-19 before receiving a new diagnosis of HIV-associated Kaposi sarcoma (KS) with widespread pulmonary and skeletal involvement. Initial differential diagnoses included
pneumonia, disseminated mycobacterial infection and bacillary angiomatosis. A bone marrow biopsy showed heavy infiltration by spindle cells, staining strongly positive for human herpes virus-8 (HHV-8) and CD34, suggesting symptomatic, disseminated KS as the unifying diagnosis. The patient commenced cytotoxic therapy with weekly paclitaxel, with a clinical and radiological response. 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McGrath, Jonathan ; Sui, Jane ; Muldoon, Eavan G</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c421t-19f036944dad871dee42c51a5031d45e38b903c469c40fbc77b9e9f073e0e9073</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Adult</topic><topic>Bacterial infections</topic><topic>Biopsy</topic><topic>Case Report</topic><topic>Case reports</topic><topic>Cell growth</topic><topic>Chemotherapy</topic><topic>Coronaviruses</topic><topic>COVID-19</topic><topic>Cytomegalovirus</topic><topic>Cytotoxicity</topic><topic>Dyspnea</topic><topic>Edema</topic><topic>Herpesvirus 8, Human</topic><topic>Histology</topic><topic>HIV</topic><topic>HIV Infections - complications</topic><topic>HIV Infections - drug therapy</topic><topic>Human immunodeficiency virus</topic><topic>Humans</topic><topic>Infections</topic><topic>Infectious diseases</topic><topic>Kaposis sarcoma</topic><topic>Lungs</topic><topic>Male</topic><topic>Medical imaging</topic><topic>Medical prognosis</topic><topic>Sarcoma, Kaposi - diagnosis</topic><topic>Sarcoma, Kaposi - drug therapy</topic><topic>SARS-CoV-2</topic><topic>Severe acute respiratory syndrome coronavirus 2</topic><topic>Transplants & implants</topic><topic>Tuberculosis</topic><topic>Tumors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Connolly, Stephen P</creatorcontrib><creatorcontrib>McGrath, Jonathan</creatorcontrib><creatorcontrib>Sui, Jane</creatorcontrib><creatorcontrib>Muldoon, Eavan G</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>BMJ case reports</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Connolly, Stephen P</au><au>McGrath, Jonathan</au><au>Sui, Jane</au><au>Muldoon, Eavan G</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Rare, disseminated Kaposi sarcoma in advanced HIV with high-burden pulmonary and skeletal involvement</atitle><jtitle>BMJ case reports</jtitle><addtitle>BMJ Case Rep</addtitle><date>2021-12-01</date><risdate>2021</risdate><volume>14</volume><issue>12</issue><spage>e245448</spage><pages>e245448-</pages><issn>1757-790X</issn><eissn>1757-790X</eissn><abstract>We describe the case of a 30-year-old man who presented to our institution with hypoxia and widespread pulmonary infiltrates managed initially as COVID-19 before receiving a new diagnosis of HIV-associated Kaposi sarcoma (KS) with widespread pulmonary and skeletal involvement. 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| subjects | Adult Bacterial infections Biopsy Case Report Case reports Cell growth Chemotherapy Coronaviruses COVID-19 Cytomegalovirus Cytotoxicity Dyspnea Edema Herpesvirus 8, Human Histology HIV HIV Infections - complications HIV Infections - drug therapy Human immunodeficiency virus Humans Infections Infectious diseases Kaposis sarcoma Lungs Male Medical imaging Medical prognosis Sarcoma, Kaposi - diagnosis Sarcoma, Kaposi - drug therapy SARS-CoV-2 Severe acute respiratory syndrome coronavirus 2 Transplants & implants Tuberculosis Tumors |
| title | Rare, disseminated Kaposi sarcoma in advanced HIV with high-burden pulmonary and skeletal involvement |
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