Clinical case of the month: a 22-year-old man with AIDS presenting with shortness of breath and an oral lesion
Englert, D.; Seal, P.; Parsons, C.; Arbour, A.; Roberts, E.; Lopez, F.A.
Journal of the Louisiana State Medical Society official organ of the Louisiana State Medical Society 166(5): 224-230
2014
ISSN/ISBN: 0024-6921 PMID: 25369228 Document Number: 675456
Since the development of combination antiretroviral therapy (cART), the incidence and mortality associated with Kaposi sarcoma (KS) have been reduced, although not eliminated. Clinical presentations of KS range from simple skin involvement to disseminated disease, including involvement of the oral cavity and viscera, which portends a more ominous prognosis. Multiple case reports and data from clinical trials indicate that administration of systemic corticosteroids may aggravate KS. We present a case of disseminated KS following administration of prednisone for presumed immune reconstitution inflammatory syndrome (IRIS) associated with fungal pneumonia in an HIV-infected individual. The discussion that follows outlines the pathophysiology and clinical presentations associated with KS and existing data for the role of corticosteroids in promoting KS progression.