Case report
A 33 year old male, single, referred for consultation in Maxillofacial
surgery at the UHC Tambohobe Fianaratsoa Madagascar for generalized
swelling of the endobuccal mucosa.
In the history of his illness, one month before his consultation, he had
been hospitalized in the pneumology department for a recent febrile
dyspnea where they found a pleurisy of medium abundance right whose
exploration found an exudative fluid with suspicious cytological
examination. During his hospitalization he had tested positive for
COVID-19 and was treated as such. One week later, there was an
appearance of swelling in the upper gum that spread and generalized
within 3 weeks.
The clinical examination on the day of the consultation, we
objectified :
-A dyspneic patient with desaturation at 92% in room air.
-A bilateral, firm, painless, mobile cervical polyadenopathy.
-Multiple generalized endobuccal nodulopapular lesions, purplish,
painless but bleeding on contact (Figure 1).
-A pleural effusion syndrome on the right
Note that he had no objectified skin lesions.
The biological tests found
-Monocytopenia and inflammatory syndrome with CRP at 24 mg/l
-HIV serology was positive
-PCR covid control was negative
X-ray showed a pleural effusion on the right.
The patient was admitted to the intensive care unit for desaturation,
which worsened to 86% on 3l oxygen.
We performed a biopsy of the lesion which revealed Kaposi’s sarcoma. He
died after 1 month of hospitalisation.