A Case of Kaposi Sarcoma Co-infected with Cytomegalovirus

Main Article Content

Amena Alkeswani
Allen Oak
Peter Pavlidakey

Keywords

Kaposi sarcoma, HHV-8, CMV, co-infection, Nodular Kaposi sarcoma

Abstract

Background: Kaposi sarcoma (KS) is the most common AIDS-associated neoplasm. It is a vascular neoplasm that occurs as a result of infection with a human herpesvirus (HHV-8). Cytomegalovirus (CMV) and HHV-8 both belong to Herpesviridae, a family of DNA viruses. CMV is highly prevalent in the general population and can cause localized or disseminated disease in AIDS patients.

Case: A 42-year-old male with an HIV infection presented with a painful ulcerated growing white nodule with overlying telangiectatic vessels on the right third toe that he noticed 4 weeks ago. A tangential biopsy revealed a vascular proliferation which was diffusely positive for HHV-8. In addition, scattered inclusion bodies were observed, indicating co-infection with CMV.

Conclusion: This case reinforces the importance of considering KS as a potential diagnosis in all AIDS patients with unusual exophytic growths to avoid potential misdiagnosis and improper management.

References

1. Schneider, J.W. and D.P. Dittmer, Diagnosis and Treatment of Kaposi Sarcoma. Am J Clin Dermatol, 2017. 18(4): p. 529-539.
2. Colugnati, F.A., et al., Incidence of cytomegalovirus infection among the general population and pregnant women in the United States. BMC Infect Dis, 2007. 7: p. 71.
3. Thakker, S. and S.C. Verma, Co-infections and Pathogenesis of KSHV-Associated Malignancies. Front Microbiol, 2016. 7: p. 151.
4. Vieira, J., et al., Activation of Kaposi's sarcoma-associated herpesvirus (human herpesvirus 8) lytic replication by human cytomegalovirus. J Virol, 2001. 75(3): p. 1378-86.
5. Crum-Cianflone, N.F., et al., Is Kaposi's sarcoma occurring at higher CD4 cell counts over the course of the HIV epidemic? AIDS, 2010. 24(18): p. 2881-3.
6. Zhang, X., et al., Simultaneous cytomegalovirus infection and Kaposi's sarcoma of the thyroid diagnosed by fine needle aspiration in an AIDS patient. A case report and first cytologic description of the two entities occurring together. Acta Cytol, 2003. 47(4): p. 645-8.