Ruzgas Gabriele, Eshan Shayet Hossain, Ramanathan Shrungavi, Gotimukul Ashwini, Bodapati Rohan K
Family and Community Medicine, University of Illinois Chicago, Chicago, USA.
Internal Medicine, Ascension Saint Joseph - Chicago, Chicago, USA.
Cureus. 2023 Feb 10;15(2):e34832. doi: 10.7759/cureus.34832. eCollection 2023 Feb.
We present a patient who was previously diagnosed with HIV and had multiple violaceous skin lesions at the time of his diagnosis. Following the initiation of antiretroviral therapy (ART), the number of lesions increased significantly and he developed shortness of breath, which prompted hospital admission for further workup. Biopsy of the skin lesions confirmed the diagnosis of Kaposi sarcoma (KS). Bronchoscopy with biopsy revealed KS lesions in his respiratory system. Imaging and biopsy confirmed KS invasion of lymph nodes. Due to widespread KS, he was diagnosed with immune reconstitution inflammatory syndrome (IRIS). Because of the lack of improvement on ART alone, he was started on chemotherapy, which decreased the size of existing skin lesions, stalled the development of new skin lesions, and led to symptom improvement. As a result of this case, we recommend that treatment teams have close follow-ups of patients started on ART and that they remain mindful of the possibility of IRIS. Disseminated KS may warrant a prompt response with chemotherapy to improve outcomes.
我们报告一名先前被诊断为感染艾滋病毒的患者，在诊断时出现了多处紫罗兰色皮肤病变。开始抗逆转录病毒治疗（ART）后，病变数量显著增加，并且他出现了呼吸急促，这促使他住院接受进一步检查。皮肤病变活检确诊为卡波西肉瘤（KS）。支气管镜检查及活检显示其呼吸系统存在KS病变。影像学检查和活检证实KS已侵犯淋巴结。由于KS广泛播散，他被诊断为免疫重建炎症综合征（IRIS）。由于仅接受ART治疗病情无改善，他开始接受化疗，化疗使现有皮肤病变缩小，阻止了新皮肤病变的发展，并使症状得到改善。基于该病例，我们建议治疗团队对开始接受ART治疗的患者进行密切随访，并时刻留意IRIS的可能性。播散性KS可能需要迅速进行化疗以改善预后。
