A painful swelling over the right lower eyelid with conjunctival injection was evaluated in a 28-year-old injection drug user. Cephalexin and corticosteroid ophthalmic drops failed to resolve the condition.
A painful swelling over the right lower eyelid with conjunctival injection was evaluated in a 28-year-old injection drug user. Cephalexin and corticosteroid ophthalmic drops failed to resolve the condition.
Dr Navin M. Amin of the Kern Medical Center in Bakersfield, Calif, writes that the patient reported weight loss and complained of increasing fatigue, fever with profuse night sweats, and watery diarrhea. In addition to the purplish lesion over the right eye, the clinical examination revealed a lean, wasted man with a temperature of 38.1°C (100.6°F). Oral candidiasis with generalized lymphadenopathy was detected.
The white blood cell count was 2,800/mL; hemoglobin, 11 g/dL; platelet count, 182,000/mL; total CD4 count, 96/mL; and HIV load, 684,720 copies/mL. A biopsy of the eyelid lesion confirmed a diagnosis of Kaposi's sarcoma.
The patient was given zidovudine, lamivudine, and nelfinavir, in addition to prophylactic trimethoprim-sulfamethoxazole. The eyelid lesion receded in 3 months.