Ambulatory Report – 3.8.17 – Hickam’s Dictum!

Thanks to Geoff Buckle for presenting a fantastic case of a 57yo M h/o HIV c/b Kaposi’s Sarcoma presenting with flu-like symptoms, ultimately found to have CAP AND Shigella/Enterotoxigenic E.Coli (ETEC.)  Hickam’s Vindicated Again!
  • Kaposi’s Sarcoma in a Nutshell!
    • Assoc w/ infection by HHV-8 —> angiogenesis, inflammation, and cellular proliferation
    • Can involved visceral organs – oral cavity, GI tract, lungs
    • Make sure to consider Bacillary angiomatosis (2/2 Bartonella) b/c can be treated with ABx
    • Dx = BIOPSY
      • Helps delineate between purpura, hematoma, angiomas, dermatofibromas, nevi
    • Tx =
      • Start ARTs!
      • Local or Intralesional chemotx
      • Systemic chemotx (if extensive cutaneous dz, symptomatic visceral involvement, or cutaneous dz unresponsive to local tx)
  • AIDS Defining Malignancies
    • There are many conditions/infections that are “AIDS-Defining”, but there are only a few AIDS Defining Malignancies =
      • Kaposi’s Sarcoma
      • Cervical Cancer
      • Non-Hodgkin’s Lymphoma
    • Other Malignancies that HIV+ patients are at higher than average risk for, but are NOT AIDS-Defining
      • Hodgkin’s Lymphoma
      • Lung, Penile, Oral cavity/Lip, Soft ts sarcomas, testicular seminomas, liver, pancreas, laryngeal

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