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BK virus encephalitis in an immunocompetent patient
Insights
A previously healthy patient developed monophasic encephalitis due to a primary BK virus infection. This case highlights the need to screen for BK virus (a human polyomavirus) in encephalitis cases.
Area of Science:
- Neurovirology
- Infectious Diseases
- Neurology
Background:
- BK virus (a human polyomavirus) is typically associated with asymptomatic infection.
- Encephalitis is a serious neurological condition characterized by inflammation of the brain.
- Primary BK virus infection causing encephalitis is rare, particularly in immunocompetent individuals.
Purpose of the Study:
- To report a case of monophasic encephalitis in a previously healthy individual.
- To identify potential risk factors associated with BK virus encephalitis.
- To raise awareness of BK virus as a cause of central nervous system infections.
Main Methods:
- A case report detailing a patient's clinical presentation and diagnostic workup.
- Diagnostic methods included serology for polyomavirus antibodies (IgM and IgG).
- Polymerase chain reaction (PCR) on cerebrospinal fluid (CSF) and cranial magnetic resonance imaging (MRI) were utilized.
Main Results:
- The patient presented with encephalitis and developed IgM and IgG antibodies against polyomavirus.
- Wild-type BK virus was confirmed in CSF samples via PCR.
- Cranial MRI revealed reversible white matter changes, predominantly on T2-weighted images.
Conclusions:
- BK virus should be considered in the differential diagnosis of encephalitis, even in previously healthy patients.
- Diagnostic testing for BK virus is recommended for patients presenting with unexplained encephalitis.
- This case underscores the neuroinvasive potential of BK virus.
Objectives:
To describe a previously healthy patient now suffering from monophasic encephalitis caused by a primary infection with BK virus and to discuss possible risk factors for developing BK virus encephalitis.
Design:
Case report.
Setting:
Referral hospital.
Patient:
The patient was examined on referral.
Main Outcome Measures:
The main diagnostic tests performed were serology, polymerase chain reaction on cerebrospinal fluid samples, and cranial magnetic resonance imaging.
Results:
During the course of the patient's encephalitis, an IgM titer developed against polyomavirus, followed by anti-polyomavirus IgG. Wild-type BK virus was demonstrated in cerebrospinal fluid samples. Cranial magnetic resonance imaging showed diffuse reversible white matter changes most prominent on T2-weighted images.
Conclusion:
We conclude that diagnostic tests for BK, a human polyomavirus, should be included in the screening program for encephalitogenic pathogens.