An interesting case of 'diabetic foot ulcer' in an HIV-positive patient.
Kaposi sarcoma is a highly vascularised tumour affecting the skin, lymph nodes and viscera. Kaposi sarcoma is most common in HIV-infected homosexual or bisexual men. We present here a 70-year-old white British male patient, who was under the care of the podiatric team for longstanding 'diabetic foot ulcers'. He was later referred to the Dermatology team who took a biopsy; this revealed features of Kaposi sarcoma which prompted an HIV test which was positive. This patient had previously presented to several healthcare professionals with symptoms suggestive of HIV infection. He was started on antiretroviral therapy and the HIV and human herpesvirus-8 viral loads became undetectable in the blood within weeks and he showed significant clinical improvement. This case report is a reminder to clinicians to have a high index of suspicion in patients presenting with symptoms and signs suggestive of HIV infection.
Department of Microbiology, Wye Valley NHS Trust, Hereford, UK venkat.sivaprakasam@wvt.nhs.uk.
Venkat
V
Sivaprakasam
Sexual Health Services, Wye Valley NHS Trust, Hereford, UK.
Catherine
C
Chima-Okereke
D000225:Adenine / Q000031:analogs & derivatives / Q000627:therapeutic use; D000368:Aged; D023241:Antiretroviral Therapy, Highly Active; D001706:Biopsy; D003841:Deoxycytidine / Q000031:analogs & derivatives / Q000627:therapeutic use; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D017719:Diabetic Foot / Q000150:complications* / Q000188:drug therapy; D000068679:Emtricitabine; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy; D006679:HIV Seropositivity / Q000150:complications / Q000188:drug therapy / Q000473:pathology / Q000821:virology; D019288:Herpesvirus 8, Human / Q000187:drug effects / Q000302:isolation & purification; D006801:Humans; D008297:Male; D063065:Organophosphonates / Q000627:therapeutic use; D012514:Sarcoma, Kaposi / Q000175:diagnosis* / Q000188:drug therapy; D012878:Skin Neoplasms / Q000188:drug therapy / Q000473:pathology* / Q000821:virology; D000068698:Tenofovir; D016896:Treatment Outcome; D014456:Ulcer / Q000209:etiology*
D063065:Organophosphonates; D003841:Deoxycytidine; D000068698:Tenofovir; D000068679:Emtricitabine; D000225:Adenine
AIDS; HIV; Kaposi sarcoma; foot ulcer; human herpesvirus-8; oncology; vascular