John Cunningham virus: Difference between revisions
From IDWiki
No edit summary |
(→) |
||
| (6 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== |
||
| ⚫ | |||
| + | *'''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 |
||
| ⚫ | |||
| ⚫ | |||
| ⚫ | |||
| − | * 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% |
||
| ⚫ | |||
| ⚫ | |||
| + | *JC virus PCR of CSF or brain biopsy |
||
| ⚫ | |||
| + | |||
| ⚫ | |||
| + | |||
| ⚫ | |||
[[Category:HIV]] |
[[Category:HIV]] |
||
| − | [[Category: |
+ | [[Category:Polyomaviridae]] |
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
