47-year-old male presents to the office with the complaint of lesions on his skin and in his mouth for one month...

in #medical7 years ago (edited)

A 47-year-old male presents to the office with the complaint of lesions on his skin and in his mouth for one month. History reveals the patient is HIV positive and has never taken anti-retroviral medications because his last CD4 count one year ago was 240 cells/µL. Physical examination reveals diffuse lymphadenopathy and a photograph of the patient's chest and face is obtained as shown in the exhibit. A punch biopsy of one of the lesions reveals multiple spindle cells, prominent vascular spaces and red blood cells.

The most likely etiologic agent is?

  1. Bartonella henselae
  2. Epstein-Barr virus
  3. human herpes virus-5
  4. human herpes virus-8
  5. Sporothrix schenckii

The most appropriate treatment is?

  1. acyclovir
  2. erythromycin
  3. ganciclovir
  4. highly active antiretroviral therapy
  5. itraconazole

answer below--->

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The most likely etiologic agent is?

human herpes virus-8
The patient in the above scenario is suffering from Kaposi’s sarcoma, which is associated with Human herpes virus – 8 (HHV-8).

Kaposi’s sarcoma was once a rare disease found almost exclusively in elderly, Mediterranean men but has become more widespread with the development of the AIDS epidemic.

Kaposi’s sarcoma is a spindle cell tumor found on the skin and solid organs of the body.

Biopsy is necessary for diagnosis and will demonstrate a proliferation of spindle cells and prominent vascular spaces.

#etiology

The most appropriate treatment is?
highly active antiretroviral therapy

Kaposi’s sarcoma usually resolves as a patient’s CD4 count increases.
For that reason, it is crucial to control the progression of HIV.
If highly active antiretroviral therapy (HAART) does not control the virus alone, chemotherapeutics or topical retinoids or interferons can be added to the treatment regimen.

#treatment