Kaposi Sarcoma Herpesvirus (KSHV) inflammatory cytokine syndrome (KICS): A case study

Background: Kaposi sarcoma herpesvirus-inflammatory cytokine syndrome (KICS) is an exceedingly rare and complex condition characterised by the co-occurrence of Kaposi sarcoma and an aberrant inflammatory response mediated by cytokines with a mortality rate up to 60% ¹ . We present a meticulously documented case report that sheds light on the distinct clinical manifestations and diagnostic and therapeutic challenges associated with this syndrome. Our report highlights the importance of accurate diagnosis, comprehensive management strategies, and the need for further research to elucidate the underlying pathophysiological mechanisms. Case Presentation: We present the case of a 59-year-old British male with a well-controlled HIV infection on Biktarvy who exhibited fever, malaise, lymphadenopathy, and splenomegaly, along with a purplish plaque on the right plantar. Further investigations revealed anaemia, thrombocytopenia, hypoalbuminemia, hyponatremia, elevated inflammatory markers, and a high HHV-8 level. Diagnosis of HHV-8 positive lymph nodes and Kaposi sarcoma on the plantar aspect was confirmed. The patient was treated with Foscarnet, steroid, Rituximab, Tocilizumab, intravenous immunoglobulin (IVIG), and Paclitaxel, reducing viral load and improving cell count. This case highlights the complexities of managing Kaposi sarcoma within the realm of immune complex syndrome. Conclusions: Our case report underscores the critical need for heightened awareness and recognition of KICS, given its rarity and unique clinical characteristics. By elucidating the complex interrelationships between Kaposi sarcoma, inflammatory cytokines, and immune dysregulation, we aim to contribute to the existing knowledge base and facilitate improved diagnosis, management, and therapeutic interventions for this challenging syndrome. Further research is warranted to explore novel treatment modalities and unravel the underlying mechanisms driving KICS.