The Conundrum of an Accumulating Acuminatum

Area of Science:

• Infectious Diseases
• Dermatology
• Oncology

Background:

• A 70-year-old male with a history of HIV, hepatitis C, and long-standing condyloma acuminatum presented with sepsis.
• Delayed treatment due to a history of heroin abuse complicated the management of severe chronic condyloma acuminatum.

Observation:

• The patient exhibited symptoms of sepsis, including hypotension, lactic acidosis, and acute-on-chronic kidney disease.
• Pelvic MRI revealed extensive condyloma acuminatum lesions infiltrating the perineum and rectal area, suspected as the source of sepsis.
• Despite broad-spectrum antibiotics, persistent leukocytosis indicated a complex infectious process.

Findings:

• Surgical biopsies confirmed low- and high-grade squamous intraepithelial neoplasia without invasive carcinoma.
• The patient underwent a diverting colostomy, resection of giant condyloma, and bowel re-anastomosis.

Implications:

• This case highlights the potential for extensive condyloma acuminatum to cause severe sepsis and renal complications.
• Multidisciplinary surgical management can effectively treat advanced condyloma acuminatum and associated sepsis.
• Early intervention is crucial for managing chronic condyloma acuminatum and preventing life-threatening complications.