Extensive bulbar conjunctival Kaposi’s sarcoma as initial symptom of human immunodeficiency virus

ABSTRACT Here, we present a case in which extensive bulbar conjunctival Kaposi’s sarcoma was the initial presentation of human immunodeficiency virus in a 36-year-old man. The patient had a 3-month history of recurrent self-limited inferior conjunctiva hyperemia in the right eye, and presented with a painless bullous lesion in the right inferior bulbar conjunctiva persisting for 15 days. Surgical incision biopsy was performed at five locations and revealed a pattern compatible with Kaposi’s sarcoma. Serologic testing was positive for human immunodeficiency virus; however, the patient had no other symptoms, or knowledge of human immunodeficiency virus infection. This case highlights the need to consider Kaposi’s sarcoma as an early presentation of human immunodeficiency virus even if the patient denies infection.

摘要 本文报告1例以广泛性球结膜卡波西肉瘤（Kaposi’s sarcoma）为首发表现的人类免疫缺陷病毒（human immunodeficiency virus）感染病例，患者为36岁男性。该患者既往有3个月病程的右眼下方结膜反复自限性充血，此次因右眼下方球结膜出现持续15天的无痛性水疱样病变就诊。研究人员对5处病灶实施手术切开活检，病理结果符合卡波西肉瘤的组织学特征。血清学检测显示人类免疫缺陷病毒呈阳性，但患者无其他相关症状，且此前并不知晓自身感染人类免疫缺陷病毒。本案例提示，即便患者否认人类免疫缺陷病毒感染史，仍需将卡波西肉瘤纳入人类免疫缺陷病毒感染早期临床表现的鉴别诊断范畴。