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A man in his 30s with an unremarkable medical history presented to the emergency department with facial lesions of several months’ duration. Ophthalmology testing was consulted. Visual acuity was 20/30 OD and 20/20 OS. The right lower eyelid had a lesion, while the remainder of the anterior segment and ophthalmoscopic examination was normal in both eyes (Figure).
Kaposi sarcoma lesion involving most of the right lower lid. There are also small nasal conjunctival lesions.
A human immunodeficiency virus (HIV) test result revealed the patient was HIV positive, with a CD4+ T-cell count of 76. A diagnosis of Kaposi sarcoma was made and systemic workup revealed pulmonary involvement, which is an unusual presentation of AIDS/HIV in 2016. Biopsy of similar lesions on the patient’s torso confirmed the diagnosis. Antiretroviral therapy and paclitaxel were commenced, with minimal effect on the lesions. External beam radiation is therefore planned, given reported success with recalcitrant skin lesions.1,2 This case highlights the importance of recognizing unusual ocular manifestations of life-threatening infections such as AIDS.
Corresponding Author: Katrina A. Mears, MD, MSc, Department of Ophthalmology, Louisiana State University, 2020 Gravier St, Ste B, New Orleans, LA 70112 (firstname.lastname@example.org).
Conflict of Interest Disclosures: All authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Dr Mears reported funding from Lions Eye Foundation and Research to Prevent Blindness. No other disclosures were reported.
Funding/Support: Supported by an unrestricted grant from Foundation Fighting Blindness.
Role of the Funder/Sponsor: The funder had no role in the preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.
Weinstein JE, Mears KA. Periocular Kaposi Sarcoma as the Initial Presentation of Human Immunodeficiency Virus. JAMA Ophthalmol. Published online October 01, 2016134(10):e162139. doi:10.1001/jamaophthalmol.2016.2139
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