John Cunningham virus: Difference between revisions

Latest revision as of 20:23, 14 August 2020

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

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%

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-* CNS infection with JC virus, usually in the context of HIV infection
+*CNS infection with JC virus, usually in the context of HIV infection
+==Background==
-= Epidemiology =
+===Epidemiology===
-* HIV patients
+*HIV patients
+==Clinical Manifestations==
-= Investigations =
+*'''Classic progressive multifocal leukoencephalopathy (PML)'''
-* MRI head: white matter changes
+**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==
-= Diagnosis =
+*MRI head: white matter changes
-* 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==
-= Treatment =
+*JC virus PCR of CSF or brain biopsy
-* Antiretroviral therapy for HIV
+==Treatment==
+*Antiretroviral therapy for HIV
 [[Category:HIV]]