[Progressive multifocal leukoencephalopathy: a complication in chronic B-cell lymphatic leukaemia]

Area of Science:

• Neurology
• Infectious Diseases
• Oncology

Background:

• Progressive multifocal leukoencephalopathy (PML) is a rare, opportunistic infection.
• It is caused by the reactivation of the JC virus, primarily affecting immunocompromised individuals.
• PML presents as sub-acute neurological deficits.

Observation:

• A 79-year-old male with chronic B-cell lymphatic leukemia (B-CLL) presented with left-sided neurological deficits.
• Initial diagnosis was stroke, but progressive symptoms and brain MRI abnormalities suggested PML.
• JC virus PCR on cerebrospinal fluid was negative.

Findings:

• Histopathological examination of a brain biopsy confirmed PML.
• This case highlights the diagnostic challenges of PML.
• JC virus PCR can produce false-negative results in early stages.

Implications:

• PML diagnosis requires a high index of suspicion in immunocompromised patients with neurological symptoms.
• Brain biopsy remains crucial for definitive PML diagnosis when PCR is inconclusive.
• Timely diagnosis is essential for appropriate patient management.