Department of Infectious Diseases, Mater Misericordiae University Hospital, Dublin, Ireland
School of Medicine, University College Dublin, Dublin, Dublin, Ireland.
BMJ Case Rep. 2021 Dec 1;14(12):e245448. doi: 10.1136/bcr-2021-245448.
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.
我们描述了一名 30 岁男性患者的病例，他因缺氧和广泛的肺部浸润到我院就诊，最初被诊断为 COVID-19，后来被诊断为 HIV 相关的卡波西肉瘤（KS），并伴有广泛的肺部和骨骼受累。最初的鉴别诊断包括肺炎、播散性分枝杆菌感染和杆菌性血管瘤病。骨髓活检显示梭形细胞大量浸润，人疱疹病毒-8（HHV-8）和 CD34 染色强阳性，提示症状性、播散性 KS 是唯一的诊断。患者开始每周接受紫杉醇细胞毒性治疗，临床和影像学均有反应。据我们所知，该病例是文献中描述的最严重的病例之一，我们对此进行了讨论，并探讨了 COVID-19 如何最初阻碍了与患者建立治疗关系。
