Table of Contents
Washington University Experience | INFECTION | Viruses | PML (JC Virus) | PML - IRIS | 3A0 Case 3 History
Case 3 History ---- This was a 44 year old man with HIV (diagnosed in 2005 with CD4 count of 41) on HAART therapy . His initial symptoms began with numbness at the right anterior thigh (lasting 1 year) followed by weakness in the left lower and upper extremities. Brain MRIs showed subcortical patchy hyperintensity on T2 and hypointensity on T1 images. CSF JC virus PCR was negative. He was continued on HAART and discharged to rehabilitation. Later in 2005 he had a brain MRI which showed progression of his lesions. In January 2006 he began having spells consisting of sensory changes marching from his toes proximally to involve the entire hemi-body over a period of seconds which were associated with tonic contraction of ipsilateral muscles without changes in consciousness. Repeat CSF analysis again revealed elevated protein and negative JC virus PCR. EEG showed only slowing over the right hemisphere consistent with focal seizures vs. paroxysmal dystonia. In May 2006 after participating in therapy, he became acutely tachycardic, dyspneic, and unresponsive. He later expired.
