Abstract
Kaposi sarcoma (KS), caused by human herpesvirus-8 (HHV-8), is among the most common malignancies in people living with HIV. Kaposi sarcoma is an angiogenic endothelial cell neoplasm and an acquired immunodeficiency syndrome (AIDS)-defining illness. Kaposi sarcoma is associated with high mortality when presenting as visceral or disseminated disease or when complicated by Kaposi sarcoma inflammatory cytokine syndrome (KICS), immune reconstitution inflammatory syndrome, or multicentric Castleman disease. We present the case of a 26-year-old male patient found to have AIDS-related KS complicated by cardiac, pulmonary, gastrointestinal, and skin involvement as well as KICS. Notably, the patient's skin lesions were not identified at the initial hospital presentation. He was treated with doxorubicin for KS and rituximab for KICS but died shortly after KICS diagnosis. We highlight the importance of recognizing KS skin lesions to aid in early diagnosis and of recognizing signs and symptoms of KICS to expedite immunomodulatory therapy initiation.