John Cunningham virus: Difference between revisions
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+ | ==Background== |
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| + | ==Clinical Manifestations== |
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| + | **Subacute onset of focal central neurological lesions |
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| + | **Asymmetric, well-demarcated, nonenchancing subcortical white matter lesions on MRI |
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| + | *'''PML-IRIS''' |
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| + | **Focal central neurological lesions following immune recovery |
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| + | **Contrast enhancing lesions with or without mass effect on MRI |
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| + | *'''JCV granule cell neuropathy''' |
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| + | **Chronic cerebellar dysfunction |
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| + | **Cerebellar atrophy on MRI |
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| + | *'''JCV encephalitis''' |
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| + | **Subacute onset of encephalopathy |
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| + | **Cortical lesions on MRI |
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| + | *'''JCV meningitis''' |
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| + | **Chronic headaches |
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| + | **Ventriculomegaly on MRI |
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| − | == |
+ | ==Investigations== |
| − | * |
+ | *MRI head: white matter changes |
| + | *CSF: fairly nonspecific, with mild pleocytosis, slightly elevated protein, and normal glucose |
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| + | **PCR of CSF has sensitivity 58% with ART or 72-92% without, and specificity 92-100% |
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| − | == |
+ | ==Diagnosis== |
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+ | *JC virus PCR of CSF or brain biopsy |
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+ | ==Treatment== |
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+ | *Antiretroviral therapy for HIV |
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| + | [[Category:HIV]] |
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| + | [[Category:Polyomaviridae]] |
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Latest revision as of 16:23, 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
