Case reports in oncology · 2026
Concurrent Monkeypox, HHV8, and Other Opportunistic Infections in a Human Immunodeficiency Virus Patient with Disseminated Kaposi Sarcoma: A Case Report.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
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Zhou Maggie H, Thomas Jeffrey A, Lipner Shari R, Matushansky Igor
Аннотация
INTRODUCTION: Human immunodeficiency virus (HIV) infection predisposes patients to opportunistic infections. Kaposi sarcoma (KS) is a soft tissue sarcoma caused by human herpesvirus-8 (HHV8). Patients with high HHV8 and HIV viremia can develop KS inflammatory cytokine storm (KICS), a rare condition characterized by severe sepsis-like symptoms and high mortality.
CASE PRESENTATION: We present a patient with poorly controlled HIV and 2 weeks of fevers, dyspnea, abdominal pain, weight loss, and tender umbilicated plaques on the face, trunk, and extremities. Along with HIV, concomitant infections included HHV8, herpes simplex virus, cytomegalovirus, methicillin-resistant Staphylococcus aureus, adenovirus, and rhinovirus/enterovirus. The skin biopsy was positive for monkeypox. Lymph node biopsy was positive for monkeypox and HHV8, and morphologically consistent with KS. The patient also had pancytopenia with multiple increased inflammatory markers.
CONCLUSION: This case highlights a diagnostic challenge. While numerous infections can cause inflammatory presentations with skin lesions and lymphadenopathy, only HHV8 is characterized by hypergammaglobulinemia. Further, in the setting of KS, HHV8 viremia is concerning for KICS. Recognizing this distinction is essential, as it shifts management from targeting infection to controlling the underlying inflammatory response.
CASE PRESENTATION: We present a patient with poorly controlled HIV and 2 weeks of fevers, dyspnea, abdominal pain, weight loss, and tender umbilicated plaques on the face, trunk, and extremities. Along with HIV, concomitant infections included HHV8, herpes simplex virus, cytomegalovirus, methicillin-resistant Staphylococcus aureus, adenovirus, and rhinovirus/enterovirus. The skin biopsy was positive for monkeypox. Lymph node biopsy was positive for monkeypox and HHV8, and morphologically consistent with KS. The patient also had pancytopenia with multiple increased inflammatory markers.
CONCLUSION: This case highlights a diagnostic challenge. While numerous infections can cause inflammatory presentations with skin lesions and lymphadenopathy, only HHV8 is characterized by hypergammaglobulinemia. Further, in the setting of KS, HHV8 viremia is concerning for KICS. Recognizing this distinction is essential, as it shifts management from targeting infection to controlling the underlying inflammatory response.