Article Text
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. Initial differential diagnoses included Pneumocystis jirovecii 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.
- COVID-19
- HIV / AIDS
- cancer - see oncology
- cancer intervention
- infections
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Footnotes
Contributors Each of the contributing authors were involved in the clinical care of the above patient and authorship of the manuscript. SPC and JMcG were clinical registrars involved in the diagnosis, work-up and treatment of the patient. SPC drafted the manuscript and obtained the images and informed written consent. JMcG contributed to the writing of the manuscript, including the discussion section. JS is the principal medical oncologist in charge of the patient’s care and assisted with the case write up and discussion. EGM is the infectious diseases consultant in charge of the patient’s care and reviewed the manuscript, making suggestions. Each had an opportunity to review the completed manuscript prior to submission.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.