Disseminated Kaposi Sarcoma With Gastrointestinal Involvement and Primary Effusion Lymphoma in an Untreated HIV Patient: A Case Report

Kaposi sarcoma (KS) and primary effusion lymphoma (PEL) are human herpesvirus-8 (HHV-8)-associated malignancies that occur predominantly in individuals with advanced, untreated HIV. We report a 30-year-old male patient with untreated HIV who presented with progressive dyspnea, cough, abdominal pain, and widespread violaceous skin lesions. Imaging revealed bilateral pleural effusions and extensive lymphadenopathy. Biopsies confirmed disseminated KS involving the skin, lymph nodes, and gastrointestinal tract, while pleural fluid cytology and immunophenotypic analysis were diagnostic of PEL. Despite initiation of antiretroviral therapy and chemotherapy, the patient developed refractory effusions, pancytopenia, and ultimately multiorgan and respiratory failure. This case highlights the aggressive nature of dual HHV-8-driven malignancies in untreated HIV patients and underscores the importance of early diagnosis and prompt antiretroviral initiation.