Polyserositis in patients with HIV and HHV-8 infection

Should we think beyond Kaposi sarcoma?

Abstract

Human herpesvirus 8 infection has been associated with different diseases like Kaposi sarcoma, multicentric Castleman disease (MCD), primary effusion lymphoma (PEL), and Kaposi sarcomaassociated herpesvirus (KSHV) inflammatory cytokine syndrome (KICS), all of which can cause pleural or pericardial effusion or ascites, but rarely simultaneous involvement of all three cavities. We present the case of a patient recently diagnosed with HIV with skin lesions suggestive of KS in whom effusions were found in all three cavities with a torpid evolution, cardiac tamponade and respiratory failure. The KS diagnosis was confirmed; however, other related conditions had to be sought, given the severity of the condition. It is important to keep in mind that KS, PEL, MCD and KICS share an etiological origin and therefore may occur simultaneously in the same patient, especially when the clinical behavior is unexpected.