Keeping an Eye Out for KS-IRIS: Kaposi Sarcoma in a Patient with Mpox

Excerpt

A 23-year-old male with HIV/AIDS and mpox who had initiated anti-retroviral therapy (ART) 3 months prior presented with dysphagia from an enlarging oral lesion. Physical exam revealed a large bleeding friable mass overlapping the incisors and canines, extensive diffuse non-tender lymphadenopathy, and multiple scattered crusted facial lesions (Fig. 1). Computed tomography showed extensive cystic/necrotic cervical, supraclavicular, and mediastinal adenopathy with ulceration/necrosis of the palatine tonsils. Biopsies of the lymph nodes and oral mass were positive for Kaposi sarcoma (KS). Due to the recent initiation of ART, the rapid progression of the disease, and the disseminated nature, this was determined to be due to immune reconstitution inflammatory syndrome (IRIS).

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