AIDS-related Kaposi sarcoma (KS) progresses rapidly with early mucosal and systemic involvement. Early diagnosis and treatment are crucial as they significantly impact the outcome. This is a case of disseminated cutaneous and gastrointestinal KS in a 24-year-old Filipino male living with HIV, presenting with hyperpigmented violaceous subcutaneous nodules, odynophagia, progressive dysphagia, and symptomatic anemia. Capsule endoscopy demonstrated utility in diagnosing gastrointestinal KS lesions, highlighting its crucial role when conventional upper endoscopy was challenging due to oropharyngeal involvement. Diagnostic limitations, mainly the unavailability of human herpesvirus-8 (HHV-8) immunohistochemical stain, were addressed through high clinical suspicion. Multidisciplinary approach including chemotherapy with liposomal doxorubicin, radiotherapy, and supportive care eventually yielded good clinical response. This case emphasizes the importance of early diagnosis, timely intervention, and long-term surveillance in achieving favorable outcomes for patients with KS despite some diagnostic limitations.
Human ; Sarcoma, Kaposi, HIV, Acquired Immunodeficiency Syndrome, Liposomal Doxorubicin

Introduction: Ruptured mycotic aortic aneurysm is a rare and life-threatening condition. An early and proper initiation of antibiotics aside from aneurysmal repair is of paramount importance. The typhidot IgG and IgM may help with this dilemma, especially when the blood culture is negative and during the waiting period for the the aortic sample result. Case: A 47-year-old male Filipino with type 2 diabetes mellitus presented with severe back pain for one month and intermittent fever for three weeks. Complete blood count showed anemia and leukocytosis with predominance of neutrophils. On computed tomography of the aorta, a segmental calcification and wall discontinuity in the right posterolateral wall of the infrarenal abdominal aorta with heterogenous collection of blood in the retroperitoneal region was seen and aortic rupture secondary to mycotic aneurysm was considered. He underwent emergency abdominal aortic aneurysm repair with debridement, antibiotic lavage, aortoiliac grafting, anastomosis and omental packing. The typhidot IgG and IgM test was positive and was given ceftriaxone 2gm/IV every 24 hours for six weeks. Blood cultures did not reveal significant growth of any pathogen. The aortic wall culture showed heavy growth for salmonella species sensitive to ceftriaxone, confirming and guiding the management. He was then discharged improved. Conclusion A mycotic aneurysm secondary to salmonella should be one of the considerations in an adult male diabetic presenting with prolonged fever, abdominal and back pain with or without a tender pulsatile mass. The Typhidot test is an easy and affordable test that allows rapid detection of salmonella infection. Early surgical intervention and antibiotics are the treatment of choice
Aneurysm, Infected ; Salmonella

STUDY DESIGN: Case ReportSETTING: National Kidney and Transplant InstituteInfective encocardits (IE) is a microbial infection of the endothelial surface of the heart usually affecting the left sided valves. Only 5-10 percent of cases of IE affect the right side, the tricuspid valve, and majority occur among injection drug users. Mortality rate is high at 25-47 percent. This is a report of successful medical treatment of an oxacillin-resistant Staphylococcus Aureus (ORSA) infective endocarditis affecting the tricuspid valve.The objectives of this paper is to present a rare case of tricuspid valve infective endocarditis in an Injection drug user and to discuss the approach in the diagnosis and management of ORSA endocarditis.The patient is a 37-year old male, Korean, on chronic intravenous nalbuphine because of pain from a fractured left tibia. He presented with a three-week history of fever, chills, cough and pleuritic chest pain later accompanied by jaundice, tea-colored urine, abdominal pain and respiratory distress. Clinically, the patient was in septic shock, with signs of tricuspid insufficiency i.e., grade 2/6 systolic murmur at the right paresternal area, distended neck veins and jaundice. Echocardiography showed vegetations on the tricuspid valve and blood cultures grew oxacillin-resistant Staphylococcus aureus (ORSA) (MIC: 2 ug/ ml). The patient also had hospital acquired pneumonia. Endotracheal tube aspirate cultures showed growth of Pseudomonas aeruginosa resistant to all antibiotics. He developed acute renal failure requiring regular hemodialysis. He was successfully treated with vancomycin, rifampicin and cotrimoxazole for the infective endocarditis, and meropenem and gentamycin for the hospital-acquired pneumonia. (Author)
Human ; Adult ; Staphylococcus Aureus ; Oxacillin ; Endocarditis, Infective ; Oxacillin Resistant Staphylococcus Aureus