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[Progressive multifocal leukoencephalopathy in HIV-negative patients for general practitioners]
Kewin Elias1, Nicolas Delaitre2, Diane Agakiza3
1Service de médecine interne générale, Centre hospitalier du Valais romand, Hôpital de Sion, 1951 Sion.
Revue Medicale Suisse
|February 5, 2026
Summary
Progressive multifocal leukoencephalopathy (PML) can affect non-HIV patients, presenting with neurological deficits. General practitioners should suspect PML, check medications, and initiate urgent workup and neurology referral.
Area of Science:
- Neurology
- Infectious Diseases
Background:
- Progressive multifocal leukoencephalopathy (PML) is a rare, opportunistic demyelinating disease.
- While historically associated with HIV/AIDS, PML occurs in other immunocompromised states.
Purpose of the Study:
- To outline a practical approach for general practitioners to recognize and manage PML.
- To emphasize early diagnosis and referral in non-HIV patients.
Main Methods:
- Review of clinical presentation and diagnostic workup for PML.
- Case illustration of PML in a polymedicated patient.
Main Results:
- PML can manifest with subacute cognitive, language, or motor impairments.
- Early recognition and intervention are crucial for patient outcomes.
Conclusions:
- General practitioners play a vital role in identifying PML in at-risk populations.
- Prompt neuroimaging, cerebrospinal fluid analysis, and specialist consultation are essential.
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