KAPOSI SARCOMA IN HIV

POSITIVE NIGERIAN
CHILDREN: CASE 2
PRESENTATION
By:
Befilia Kapitia 202057437
Rosemary Andam 221295526
Benitia Aihuki 221322779
Etuama Nambinga 221313060
Vistorina Eita 221306870
Puseletso Taleng 221294287
Kenneth Matovu 201303313
Edward Muyakui 218202660
Daniel Simaata 221056475
Ralitsa Katzao 202022854
Objective (s) of the case report
• To document and to alert clinicians to the possibility of Kaposi Sarcoma diagnosis in
HIV infected children in Nigeria.
• To document the progression of Kaposi Sarcoma cases in HIV infected children in
Nigeria
• To document the management and response to therapy and to raise suspicion of Kaposi
Sarcoma when there is presence of mucocutaneous lesions in HIV infected children.
Patient demographic:
Age:9 years old
Sex:male
Race: Black
Admission date: February 2009
Address: Nigeria
Signs and symptoms during the first presentation at the health facility:

• Cough of 3 months duration, Neck and scalp swellings, Painless protrusion from the
right eye of 2 months duration, Watery eye discharge, Gradual loss of vision, Wasting,
Extensive scaly lesions on the scalp, mildly pale,
• Afebrile, Anicteric, Generalized lymphadenopathy, No peripheral oedema, Fungating
nodular mass protruding from the right eye, Nodular swellings on the right temporal
region and lower limbs, Stunting, Noisy breathing, Intercostal recessions with a
respiratory rate of 36 breaths per minute,
• Reduced air entry on the left lower lung zone, Bronchial breath sounds on the right
upper and mid lung zone, there was hepatomegaly of 4 cm below the right costal
margin, Collapse of the right upper lobe, Compensatory emphysema of the right
middle and lower lobes and the left lung.

,
Tests carried out at the health facility:
• He received a chest radiograph- showed collapse of the right upper lobe with compensatory emphysema
of the right middle and lower lobes and the left lung.
• Mantoux test and sputum microscopy for Acid Fast Bacilli- negative.
• His haematocrit was 19% and serum electrolytes, Urea and creatinine were within normal limits.
• Rapid HIV test- showed reactive and was confirmed by Western Blot. His CD4 count was 72 cells/ul and
viral load was 168,041 copies/ml.
• Hepatitis C antibody test positive and negative to Hepatitis B surface antigen test tested negative.
• He was diagnosed to have WHO clinical stage 4 HIV Infection with possible disseminated Tuberculosis
(pulmonary, abdominal, lymph node).
Medications received:
• He received antibiotics for suspected pyogenic pneumonia, ketoconazole.
• Cotrimoxazole for treatment of Pneumocystis pneumonia
• Anti tuberculosis therapy.
• ART (anti-retro viral treatment) was commenced two weeks later.
• Did not receive chemotherapy treatment, only a workup was done on the patient in preparation for chemotherapy.

Overall recommendations
• Patients should have visited doctors upon discovery of a persistent cough.
• Though done in case study immediate resting of tuberculosis should be done.
• With protrusion of eye and discharge from the eye patient should have gone to optometrist.
• Various tests should be carried out to investigate patients underweight and stunt growth.
• Autopsy should have been done to find out the causative agent for parents' death .In case of genetic health condition.

Patient outcome
This patient alongside the fact that they had HIV developed underlying respiratory infections that had been an open
gateway to progression of HIV into AIDS thus the invasion of body by cancerous cells, viral infections and diseases.
Detection was too late causing patient to succumb to illness.

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