John Cunningham virus: Difference between revisions
From IDWiki
No edit summary |
(→) |
||
| (4 intermediate revisions by the same user not shown) | |||
| Line 1: | Line 1: | ||
* |
*CNS infection with JC virus, usually in the context of HIV infection |
||
== |
==Background== |
||
===Epidemiology=== |
|||
* |
*HIV patients |
||
==Clinical Manifestations== |
|||
== Investigations == |
|||
*'''Classic progressive multifocal leukoencephalopathy (PML)''' |
|||
| ⚫ | |||
**Subacute onset of focal central neurological lesions |
|||
**Asymmetric, well-demarcated, nonenchancing subcortical white matter lesions on MRI |
|||
*'''PML-IRIS''' |
|||
**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 |
|||
== |
==Investigations== |
||
| ⚫ | |||
* JC virus PCR |
|||
*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% |
|||
== |
==Diagnosis== |
||
*JC virus PCR of CSF or brain biopsy |
|||
| ⚫ | |||
==Treatment== |
|||
| ⚫ | |||
[[Category:HIV]] |
[[Category:HIV]] |
||
Latest revision as of 20:23, 14 August 2020
- CNS infection with JC virus, usually in the context of HIV infection
Background
Epidemiology
- 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
- PML-IRIS
- 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
Investigations
- 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%
Diagnosis
- JC virus PCR of CSF or brain biopsy
Treatment
- Antiretroviral therapy for HIV
