Systemic viremia with multiple organ involvement is the major cause of morbidity and mortality. The organ systems involved include the liver, lungs, brain, gastrointestinal tract and adrenal glands. Septicemia from secondary bacterial infections of skin lesions also contributes to the morbidity and mortality of these patients. A beta-hemolytic streptococci, Pseudomonas aeruginosa and Peptostreptococcus spp. were found to be the major isolates from patients with secondary bacterial infections. When Kaposi varicelliform eruption due to herpes simplex virus involves the face, there is a risk of ocular involvement leading to blepharitis, conjunctivitis, keratitis and uveitis.
Herpetic keratitis can lead to blindness due to stromal scarring.
Interestingly, there have been very few reported cases of ocular herpetic disease in Kaposi varicelliform eruption, even when there have been positive conjunctival HSV cultures. In a German study of 75 cases of Kaposi varicelliform eruption, the age of onset ranged from 5 months to 69 years. Kaposi varicelliform eruption begins as clusters of umbilicated vesiculopustules in areas where the skin has been affected by a preexistent dermatitis. Frequently there is a delay in diagnosis because the eruption is confused with the underlying disease until the characteristic umbilicated vesiculopustules appear. The eruption continues to spread over a period of 7-10 days and may be associated with high temperature, malaise and lymphadenopathy.