John Cunningham virus: Difference between revisions
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* '''Classic PML''' |
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** Subacute onset of focal central neurological lesions |
** Subacute onset of focal central neurological lesions |
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Revision as of 19:13, 14 July 2020
- CNS infection with JC virus, usually in the context of HIV infection
Background
Epidemiology
- HIV patients
Clinical Manifestations
- Classic 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
