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Progressive multifocal leukoencephalopathy in an HIV patient: A case report and literature review
Ting Lei1, Ai Deng1, Lianchi Li2
1Center of Infectious Diseases, West China Hospital Sichuan University Chengdu China.
Key Clinical Message:
Progressive multifocal leukoencephalopathy (PML) is a rare opportunistic infection of the brain caused by reactivation of the JC virus, which can lead to a lytic infection of oligodendrocytes. We report a patient with HIV who developed PML.
Abstract:
Progressive multifocal leukoencephalopathy (PML) is a rare opportunistic infection of the brain caused by reactivation of the John Cunningham virus (JCV), which can lead to a lytic infection of oligodendrocytes. Herein, we report the case of a patient with HIV who developed PML that presented as a progressive disturbance of consciousness and movement. The patient's clinical symptoms progressively deteriorated, and positive JC viral DNA in his cerebrospinal fluid (CSF) helped us diagnose him with PML. Magnetic resonance imaging (MRI) showed multiple asymmetric subcortical and deep white-matter lesions. Although we administered immunoreconstructive therapy, the patient's condition gradually worsened. Therefore, we suggest that PML should be considered if such lesions are found in MRIs of HIV patients.
Insights
Progressive multifocal leukoencephalopathy (PML), a brain infection from JC virus reactivation, can occur in HIV patients. Early MRI detection of white-matter lesions is crucial for diagnosis and management.
Area of Science:
- Neuroscience
- Infectious Diseases
- Virology
Background:
- Progressive multifocal leukoencephalopathy (PML) is a rare, opportunistic brain infection.
- It is caused by the John Cunningham virus (JCV), leading to oligodendrocyte lysis.
- PML is particularly associated with conditions that compromise the immune system, such as HIV/AIDS.
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