John Cunningham virus

From IDWiki
  • CNS infection with JC virus, usually in the context of HIV infection



  • HIV patients

Clinical Manifestations

  • Classic progressive multifocal leukoencephalopathy (PML)
    • Subacute onset of focal central neurological lesions
    • Asymmetric, well-demarcated, nonenchancing subcortical white matter lesions on MRI
    • Focal central neurological lesions following immune recovery
    • Contrast enhancing lesions with or without mass effect on MRI
  • JCV granule cell neuropathy
    • Chronic cerebellar dysfunction
    • Cerebellar atrophy on MRI
  • JCV encephalitis
    • Subacute onset of encephalopathy
    • Cortical lesions on MRI
  • JCV meningitis
    • Chronic headaches
    • Ventriculomegaly on MRI


  • MRI head: white matter changes
  • CSF: fairly nonspecific, with mild pleocytosis, slightly elevated protein, and normal glucose
    • PCR of CSF has sensitivity 58% with ART or 72-92% without, and specificity 92-100%


  • JC virus PCR of CSF or brain biopsy


  • Antiretroviral therapy for HIV