JC virus-induced progressive multifocal leukoencephalopathy in a presumably healthy patient

Area of Science:

• Neurovirology
• Neuropathology
• Infectious Diseases

Background:

• JC virus (JCV) is typically latent in healthy individuals but can reactivate under immunosuppression, causing progressive multifocal leukoencephalopathy (PML).
• PML is a rare, severe demyelinating disease of the central nervous system.

Observation:

• A 67-year-old immunocompetent female presented with rapidly progressive dementia.
• Brain biopsy confirmed JC virus infection as the cause of lesions.
• Standard treatments, including corticosteroids, were ineffective.

Findings:

• High-throughput DNA sequencing identified JC virus infection.
• A combination therapy including mirtazapine, mefloquine, and traditional Chinese herbs led to disease stabilization.
• This case demonstrates JC virus can cause PML in seemingly healthy individuals.

Implications:

• This case expands the understanding of JC virus pathogenesis in immunocompetent hosts.
• Findings may inform therapeutic strategies for rare viral encephalitis, especially in the context of other viral epidemics.
• Highlights the importance of considering opportunistic infections even in immunocompetent patients presenting with neurological decline.