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== |
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*MRI head: white matter changes |
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*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 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
