{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T14:40:19Z","timestamp":1756305619015,"version":"3.44.0"},"reference-count":20,"publisher":"BMJ","issue":"4","funder":[{"DOI":"10.13039\/100000057","name":"National Institute of General Medical Sciences","doi-asserted-by":"publisher","award":["T32GM007739"],"award-info":[{"award-number":["T32GM007739"]}],"id":[{"id":"10.13039\/100000057","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2020,4,1]]},"published-print":{"date-parts":[[2020,4]]},"abstract":"<jats:p>In the era of highly active antiretroviral therapy (HAART), disseminated Kaposi sarcoma (KS) has become much rarer in the USA. We report a case of a 34-year-old man with KS of the skin, oropharynx, lung and rectum. Within the same lung nodule, we discovered significant burden of colesional <jats:italic>Cryptococcus neoformans,<\/jats:italic> in the context of a positive asymptomatic cryptococcal antigenemia, which was a previously unreported occurrence. The gold standard of treatment for KS continues to be HAART. The role of chemotherapy is still controversial. In addition, a cryptococcal antigen screen-and-treat approach with fluconazole is still not routinely recommended in the USA to prevent serious meningeal disease despite recent studies showing efficacy and applicability. We discuss both issues here and the outcome of our patient. We also present the patient\u2019s own unique perspective in dealing with the ramifications of these diagnoses.<\/jats:p>","DOI":"10.1136\/bcr-2019-233860","type":"journal-article","created":{"date-parts":[[2020,4,15]],"date-time":"2020-04-15T05:09:26Z","timestamp":1586927366000},"page":"e233860","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Diagnostic and management considerations in the modern patient with AIDS: a case of concurrent disseminated Kaposi sarcoma and colesional <i>Cryptococcus neoformans<\/i>"],"prefix":"10.1136","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1916-1579","authenticated-orcid":false,"given":"Samuel Clay","family":"Williams","sequence":"first","affiliation":[{"name":"Tri-Institutional MD PhD Program, Weill Cornell Medical College, New York, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jacob","family":"Sweeney","sequence":"additional","affiliation":[{"name":"Weill Cornell Medicine Department of Pathology and Laboratory Medicine, New York, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lalitha","family":"Parameswaran","sequence":"additional","affiliation":[{"name":"Department of Medicine, NYU Langone Medical Center, New York, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2020,4,14]]},"reference":[{"key":"2025082707101128000_13.4.e233860.1","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1038\/s41572-019-0060-9","article-title":"Kaposi sarcoma","volume":"5","author":"Cesarman","year":"2019","journal-title":"Nat Rev Dis Primers"},{"key":"2025082707101128000_13.4.e233860.2","doi-asserted-by":"publisher","DOI":"10.3389\/fmicb.2011.00175"},{"key":"2025082707101128000_13.4.e233860.3","article-title":"Recognition of dual or multiple pathology in skin biopsies from patients with HIV\/AIDS","volume":"2011","author":"Grayson","year":"2011","journal-title":"Patholog Res Int"},{"key":"2025082707101128000_13.4.e233860.4","doi-asserted-by":"crossref","first-page":"780","DOI":"10.1097\/DAD.0b013e3181dbc5de","article-title":"Cutaneous colesional acquired immunodeficiency syndrome associated Kaposi sarcoma and cryptococcosis","volume":"32","author":"Ramdial","year":"2010","journal-title":"Am J Dermatopathol"},{"key":"2025082707101128000_13.4.e233860.5","doi-asserted-by":"crossref","first-page":"480","DOI":"10.1111\/j.1365-2230.1995.tb01383.x","article-title":"Cutaneous cryptococcosis and Kaposi's sarcoma occurring in the same lesions in a patient with the acquired immunodeficiency syndrome","volume":"20","author":"Glassman","year":"1995","journal-title":"Clin Exp Dermatol"},{"key":"2025082707101128000_13.4.e233860.6","doi-asserted-by":"crossref","first-page":"676","DOI":"10.1016\/j.jaad.2008.12.052","article-title":"Coexistent Kaposi sarcoma, cryptococcosis, and Mycobacterium avium intracellulare in a solitary cutaneous nodule in a patient with AIDS: report of a case and literature review","volume":"62","author":"Pietras","year":"2010","journal-title":"J Am Acad Dermatol"},{"key":"2025082707101128000_13.4.e233860.7","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.1990.01670290131028"},{"key":"2025082707101128000_13.4.e233860.8","doi-asserted-by":"crossref","DOI":"10.1186\/s13256-019-1982-2","article-title":"Severe clinical immunodeficiency in a patient with human immunodeficiency virus infection and relatively high CD4 counts: a case report","volume":"13","author":"Essouma","year":"2019","journal-title":"J Med Case Rep"},{"key":"2025082707101128000_13.4.e233860.9","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2013.51.6757"},{"key":"2025082707101128000_13.4.e233860.10","doi-asserted-by":"publisher","DOI":"10.1007\/s00408-015-9830-7"},{"key":"2025082707101128000_13.4.e233860.11","doi-asserted-by":"publisher","DOI":"10.1186\/1750-1172-4-18"},{"key":"2025082707101128000_13.4.e233860.12","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.11816"},{"key":"2025082707101128000_13.4.e233860.13","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-1293.2006.00378.x"},{"key":"2025082707101128000_13.4.e233860.14","first-page":"CD003256","article-title":"Treatment of severe or progressive Kaposi's sarcoma in HIV-infected adults","volume":"8","author":"Gbabe","year":"2014","journal-title":"Cochrane Database Syst Rev"},{"key":"2025082707101128000_13.4.e233860.15","doi-asserted-by":"publisher","DOI":"10.1016\/j.idc.2015.10.006"},{"key":"2025082707101128000_13.4.e233860.16","unstructured":"World Health Organization . Rapid advice : diagnosis pamocdiH-ia, adolescents and children : December 2011. World Health Organization., 2011. Available: https:\/\/apps.who.int\/iris\/handle\/10665\/44786"},{"key":"2025082707101128000_13.4.e233860.17","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-3156.2007.01874.x"},{"key":"2025082707101128000_13.4.e233860.18","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0069288"},{"key":"2025082707101128000_13.4.e233860.19","doi-asserted-by":"crossref","first-page":"S331","DOI":"10.1097\/QAI.0000000000000484","article-title":"Cryptococcal antigen screening and early antifungal treatment to prevent cryptococcal meningitis: a review of the literature","volume":"68 Suppl 3","author":"Kaplan","year":"2015","journal-title":"J Acquir Immune Defic Syndr"},{"key":"2025082707101128000_13.4.e233860.20","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciu937"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2019-233860","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T14:10:19Z","timestamp":1756303819000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2019-233860"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,4]]},"references-count":20,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2020,4,14]]},"published-print":{"date-parts":[[2020,4]]}},"alternative-id":["10.1136\/bcr-2019-233860"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2019-233860","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2020,4]]}}}