Upper airway obstruction secondary to acquired immunodeficiency syndrome-related Kaposi's sarcoma

A 45-year-old man with a history of intravenous drug use presented with acute respiratory distress. A pulsus paradoxus of 42 mm Hg, accessory respiratory muscle use and stridor were present. Examination of the oropharynx revealed multiple 1 to 2 cm purple lesions of the gingiva and hard palate. A purple tumor mass in the posterior pharynx obstructed the view of the larynx. An emergency tracheostomy was performed resulting in hemorrhage into the respiratory tract. Autopsy revealed disseminated Kaposi's sarcoma and large blood clots in the trachea and main stem bronchus. This case illustrates the occurrence of life threatening involvement of the upper aerodigestive tract with Kaposi's sarcoma and hemorrhagic complications resulting from surgical manipulation.