An Atypical Presentation of Progressive Multifocal Leukoencephalopathy With Newly Diagnosed HIV Infection
Progressive multifocal leukoencephalopathy (PML) is a rare demyelinating infectious disease of the central nervous system that typically presents in immunosuppressed patients with history of AIDS, hematologic malignancies, or immunosuppressant drug treatment. We report a case that highlights the imp...
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| Format: | Article |
| Language: | English |
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American College of Physicians
2023-01-01
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| Series: | Annals of Internal Medicine: Clinical Cases |
| Online Access: | https://www.acpjournals.org/doi/10.7326/aimcc.2022.0809 |
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| author | Kishan V. Patel Abhishek Dutta Marcela K. Roger |
| author_facet | Kishan V. Patel Abhishek Dutta Marcela K. Roger |
| author_sort | Kishan V. Patel |
| collection | DOAJ |
| description | Progressive multifocal leukoencephalopathy (PML) is a rare demyelinating infectious disease of the central nervous system that typically presents in immunosuppressed patients with history of AIDS, hematologic malignancies, or immunosuppressant drug treatment. We report a case that highlights the importance of differentiating PML from acute/chronic ischemic stroke. Distinction is made between acute ischemic stroke and demyelinating disease with the T2-gradient recalled-echo weighted imaging. Failure to test for HIV in patients with suspected chronic ischemic stroke can lead to increased morbidity, decreased highly active antiretroviral therapy efficacy, and poorer patient outcomes. Clinicians should strongly consider PML in immunocompromised patients with frequent, progressive neurologic symptoms. |
| format | Article |
| id | doaj-art-e8427b83df5949ee9c2ef8f2aacb0d81 |
| institution | DOAJ |
| issn | 2767-7664 |
| language | English |
| publishDate | 2023-01-01 |
| publisher | American College of Physicians |
| record_format | Article |
| series | Annals of Internal Medicine: Clinical Cases |
| spelling | doaj-art-e8427b83df5949ee9c2ef8f2aacb0d812025-08-20T03:18:08ZengAmerican College of PhysiciansAnnals of Internal Medicine: Clinical Cases2767-76642023-01-012110.7326/aimcc.2022.0809An Atypical Presentation of Progressive Multifocal Leukoencephalopathy With Newly Diagnosed HIV InfectionKishan V. Patel0Abhishek Dutta1Marcela K. Roger21Jefferson Health NJ, Stratford, New Jersey1Jefferson Health NJ, Stratford, New Jersey1Jefferson Health NJ, Stratford, New JerseyProgressive multifocal leukoencephalopathy (PML) is a rare demyelinating infectious disease of the central nervous system that typically presents in immunosuppressed patients with history of AIDS, hematologic malignancies, or immunosuppressant drug treatment. We report a case that highlights the importance of differentiating PML from acute/chronic ischemic stroke. Distinction is made between acute ischemic stroke and demyelinating disease with the T2-gradient recalled-echo weighted imaging. Failure to test for HIV in patients with suspected chronic ischemic stroke can lead to increased morbidity, decreased highly active antiretroviral therapy efficacy, and poorer patient outcomes. Clinicians should strongly consider PML in immunocompromised patients with frequent, progressive neurologic symptoms.https://www.acpjournals.org/doi/10.7326/aimcc.2022.0809 |
| spellingShingle | Kishan V. Patel Abhishek Dutta Marcela K. Roger An Atypical Presentation of Progressive Multifocal Leukoencephalopathy With Newly Diagnosed HIV Infection Annals of Internal Medicine: Clinical Cases |
| title | An Atypical Presentation of Progressive Multifocal Leukoencephalopathy With Newly Diagnosed HIV Infection |
| title_full | An Atypical Presentation of Progressive Multifocal Leukoencephalopathy With Newly Diagnosed HIV Infection |
| title_fullStr | An Atypical Presentation of Progressive Multifocal Leukoencephalopathy With Newly Diagnosed HIV Infection |
| title_full_unstemmed | An Atypical Presentation of Progressive Multifocal Leukoencephalopathy With Newly Diagnosed HIV Infection |
| title_short | An Atypical Presentation of Progressive Multifocal Leukoencephalopathy With Newly Diagnosed HIV Infection |
| title_sort | atypical presentation of progressive multifocal leukoencephalopathy with newly diagnosed hiv infection |
| url | https://www.acpjournals.org/doi/10.7326/aimcc.2022.0809 |
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