July 3, 1981 / Vol . 30 / No. 25

Epidemiologic Notes and Reports

Table of

Contents

• 305 Kaposi's Sarcoma and Pneumocystis Pneumonia Among Homosexual Men - New York City and California
• 308 Cutaneous Larva Migrans in American Tourists - Martinique and Mexico
• 314 Measles - U.S. Military Kaposi's Sarcoma and Pneumocystis Pneumonia Among Homosexual Men - New York City and California

Epidemiologic Notes and Reports

During the past 30 months, Kaposi's sarcoma (KS), an uncommonly reported malignancy in the United States, has been diagnosed in 26 homosexual men (20 in New York City [NYC]; 6 in California). The 26 patients range in age from 26-51 years (mean 39 years) . Eight of these patients died (7 in NYC, 1 in California)-all 8 within 24 months after KS was diagnosed. The diagnoses in all 26 cases were based on histopathological examination of skin lesions, lymph nodes, or tumor in other organs. Twenty-five of the 26 patients were white, 1 was black. Presenting complaints from 20 of these patients are shown in Table 1.

Skin or mucous membrane lesions, often dark blue to violaceous plaques or nodules, were present in most of the patients on their initial physician visit. However, these lesions were not always present and often were considered benign by the patient and his physician.

A review of the New York University Coordinated Cancer Registry for KS in men under age 50 revealed no cases from 1970-1979 at Bellevue Hospital and 3 cases in this age group at the New York University Hospital from 1961-1979.

Seven KS patients had serious infections diagnosed after their in itial physician visit. Six patients had pneumonia (4 biopsy confirmed as due to Pneumocystis carinii [PC]), and one had necrotizing toxoplasmosis of the central nervous system. One of the patients
with Pneumocystis pneumonia also experienced severe, recurrent, herpes simplex infection; extensive candidiasis; and cryptococcal meningitis. The results of tests for cytomegalovirus (CMV) infection were available for 12 patients. All 12 had serological evidence
of past or present CMV infection. In 3 patients for whom culture results were available, CMV was isolated from blood, urine and/or lung of all 3. Past infections with amebiasis and hepatitis were commonly reported.

TABLE 1.

Presenting complaints in 20 patients with Kaposi's sarcoma

Presenting complaint - Number (percentage) of patients
Skin lesion(s) only - 10 (50%)
Skin lesions plus lymphadenopathy - 4 (20%)
Oral mucosa! lesion only - 1 (5%)
Inguinal adenopathy plus perirectal abscess - 1 (5%)
Weight loss and fever - 2 (10%)
Weight loss, fever, and pneumonia (one due to Pneumocystis carinii) - 2 (10%)

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES/ PUBLIC HEALTH SERVICE