Skip to content

Advertisement

  • Poster presentation
  • Open Access

Challenges in treating HIV-infected patient with disseminated Kaposi`s sarcoma and miliary TB

  • 1,
  • 1, 2,
  • 1 and
  • 1, 2
BMC Infectious Diseases201414(Suppl 4):P42

https://doi.org/10.1186/1471-2334-14-S4-P42

Published: 29 May 2014

Keywords

  • Pericarditis
  • Pleural Fluid
  • Malignant Pleural Effusion
  • Human Herpesvirus
  • Pleurisy

Kaposi`s Sarcoma (KS) is the most common malignancy in HIV-infected patients. It`s induced by an infection with the Human Herpesvirus 8. AIDS-related Kaposi sarcoma tends to have an aggressive clinical course because it may involve all skin, membranes, lymph nodes, stomach, gut, lung or liver.

A 32-year-old patient was diagnosed in 2009 with HIV infection and disseminated KS. Purple macules and nodules were disseminated on the trunk, limbs and lingual mucosa. He was a late presenter with CD4-T cell count 30 cells/µL and 108,000 copies/mL HIV-RNA. With antiretroviral therapy (ART) the clinical, virological and immunological evolution were very good: the CD4-T cell count increased to 156 cells/µL and the viral load was undetectable. Unfortunately, he became non adherent, and after 2 years of absence he returned in very bad condition with pericarditis, pleurisy, ascites and a low CD4-T cell count (13 cells/µL). The changes showed by the chest CT scan, the results of pleural biopsy, the clinical findings raised the suspicion of disseminated KS and miliary tuberculosis. Despite all the treatments (Mega-ART, antituberculosis chemotherapy, opportunistic infections prophylaxis) the pericarditis and pleural fluid was always recovered. Weekly thoracentesis were needed and CD-4 T cell number had not increased as we expected (the maximal value was 88 cells/µL), although the viremia was undetectable.

There are 5 years since our patient was diagnosed with HIV infection and disseminated KS. In front of a patient with HIV-infection and symptomatic visceral or pulmonary KS, regardless the viral load, cytotoxic chemotherapy is recommended after the immunological status is improved. Another option is thoracoscopic talc pleurodesis which has been reported extremely effective in the malignant pleural effusion.

Authors’ Affiliations

(1)
Clinical Hospital of Infectious Diseases, Constanța, Romania
(2)
Ovidius University, Constanța, Romania

Copyright

© Iancu et al; licensee BioMed Central Ltd. 2014

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

Advertisement