Multiple Giant Molluscum Contagiosum Mimicking Epidermal Cysts in an HIV-Positive Patient with Miliary Tuberculosis: A Case Report

Abstract

Introduction: Molluscum Contagiosum (MC) is a benign cutaneous viral infection caused by a double-stranded DNA virus of the family poxviridae. In patients with human immunodeficiency virus (HIV) infection, lesions often spread widely, atypical and don't show signs of self-healing. Here we report a case of multiple giant Molluscum Contagiosum in an HIV-positive patient with miliary tuberculosis. Case presentation: A 26-year-old man presented with a 1-year history of symmetrical exophytic lesions，physical examination showed that these lesions distributed over the bilateral thighs, and some giant papules reached 2 cm in diameter. He had a dry cough with little phlegm production, a low-grade fever, and fatigue for 8 months. The patient was finally diagnosed with MC, miliary tuberculosis and HIV infection. He was given anti-tuberculosis and antiviral treatment，the effect of cryotherapy on MC was unsatisfactory and the patient was lost to follow-up. Discussion: Molluscum contagiosum is a kind of infectious disease, which is easy to be diagnosed by clinical manifestations and laboratory examination. It is self-healing in patients with normal immunity, but in patients with immunodeficiency, the rash is often atypical and difficult to treat, and patients are also easy to merge with other microbial infections. Conclusion: Clinicians must bear in mind that patients with multiple giant molluscum contagiosum infections need to be excluded of HIV and other infectious diseases to avoid missed diagnosis and misdiagnosis.