Severe Kaposi’s Sarcoma Accompanied by Secondary Candida Infection in

Patient with AIDS: A Case Report

I Nyoman Gede Juwita Putra1, Irna Sufiawati2, Yovita Hartantri3
1
Oral Medicine Specialist Program, Faculty of Dentistry, Universitas Padjadjaran, Dr. Hasan Sadikin
Hospital,Bandung-Indonesia
2
Oral Medicine Department, Faculty of Dentistry, Universitas Padjadjaran, Dr. Hasan Sadikin Hospital, Bandung-
Indonesia
3
Internal Medicine Department, Faculty of Medicine, Universitas Padjadjaran, Dr. Hasan Sadikin Hospital,
Bandung-Indonesia
Correspondence: nyomangedejputra@gmail.com

Abstract
Objective. The purpose of this case report is to describe the occurrence of Kaposi's sarcoma
(KS) with secondary Candida infection in patients with AIDS.
Case and Management. A 23-year-old male was referred from the tropic disease and infection
division department of internal medicine to oral medicine division with complaints of a lump on
the palate since 3 months ago, at first time was appear on the right belly and increasing over
time, accompanied by white patch throughout the oral cavity. Extraoral examination revealed the
presence of multiple purplish red plaques on the face and several parts such as the hands and
belly, also ulcerative lesions at the corners of the left lip and felt sore when opening the mouth.
Intraoral examination showed the presence of purplish red plaques on the palate and gingiva, and
white plaques almost throughout the oral cavity. Microbiological examination showed the
presence of yeast in the oral cavity. Based on histopathological examination this patient was
diagnosed with Kaposi's sarcoma and based on microbiological examination this patient was
diagnosed with oral candidiasis, ulcers, oral thrush also angular cheilitis. This patient was given
nystatin oral suspension 4 times a day and a topical miconazole gel. White plaque in the oral
cavity disappears on the 12th day, 5 days after miconazole therapy. The epithelial surface in HIV
infection associated with Kaposi's sarcoma shows secondary Candida infection with various
levels of tissue invasion. There are findings as many as 40.6% of patients with HIV-Kaposi's
sarcoma suffer from secondary Candida infections. Candida infection regardless of severity
rarely reaches the lamina propria by penetration through the epithelium. In the single case where
the organism penetrated connective tissue and Kaposi's Sarcoma tissue, it entered through the
necrotic ulcerated surface, and not through the intact epithelium.
Conclusion. Secondary Candida infection in patient with HIV-Kaposi’s sarcoma is commonly
infected with large numbers of Candida organism.

Keywords : Candida infection, HIV/AIDS, kaposi’s sarcoma

Figure : (A). Purplish red plaques on the palate and gingival, (B). White patch on dorsum and lateral of
the tongue, (C,D). Histopathological image showed a stratified squamous epithelium with a
fibrocollagenous stroma within which are seen proliferating plump spindle cells with slit-likevascular
channels