title: Clinical case of the month: a 22-year-old man with AIDS presenting with shortness of breath and an oral lesion.
abstract: 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.
authors.affiliation: Chief Resident of the Louisiana State University Health Sciences Center Internal Medicine Residency Program.
authors.forename: Daniel
authors.initials: D
authors.lastname: Englert
authors.affiliation: Assistant Professor of Medicine at Louisiana State University Health Sciences Center in New Orleans in the section of Infectious Diseases.
authors.forename: Paula
authors.initials: P
authors.lastname: Seal
authors.affiliation: Associate Professor of Medicine and Microbiology and Director of the HIV Cancer Care Program at Louisiana State University Health Sciences Center in New Orleans.
authors.forename: Chris
authors.initials: C
authors.lastname: Parsons
authors.affiliation: former Chief Resident of Louisiana State University Health Sciences Center in New Orleans Internal Medicine Residency Program.
authors.forename: Adrienne
authors.initials: A
authors.lastname: Arbour
authors.affiliation: Resident in the Tulane University Pathology and Laboratory Medicine Program.
authors.forename: Evans
authors.initials: E
authors.lastname: Roberts
authors.affiliation: Richard Vial Professor and Vice Chair for Education in the Department of Medicine at LSUHSC-New Orleans.
authors.forename: Fred A
authors.initials: FA
authors.lastname: Lopez
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000150:complications / Q000188:drug therapy / Q000473:pathology / Q000503:physiopathology; D000328:Adult; D006801:Humans; D008172:Lung Diseases, Fungal / Q000188:drug therapy / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D008297:Male; D009062:Mouth Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000503:physiopathology; D011014:Pneumonia / Q000188:drug therapy / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D012514:Sarcoma, Kaposi / Q000188:drug therapy / Q000473:pathology / Q000503:physiopathology