Email updates

Keep up to date with the latest news and content from BMC Neurology and BioMed Central.

Open Access Case report

Progressive multifocal leucoencephalopathy in an immunocompetent patient with favourable outcome. A case report

Halvor Naess1*, Solveig Glad1, Anette Storstein1, Christine H Rinaldo2, Sverre J Mørk3, Kjell-Morten Myhr1 and Hans Hirsch4

Author Affiliations

1 Department of Neurology, Haukeland University Hospital, N-5021 Bergen, Norway

2 Department of Microbiology and Infection Control, University Hospital of North Norway, N-9038 Tromsø, Norway

3 Department of Pathology, Haukeland University Hospital, N-5021 Bergen, Norway

4 Div. Molecular Diagnostics, Clinical & Transplantation Virology, Institute for Medical Microbiology, Petersplatz 10, CH-4003 Basel, Switzerland

For all author emails, please log on.

BMC Neurology 2010, 10:32  doi:10.1186/1471-2377-10-32

Published: 18 May 2010

Abstract

Background

To report the clinical course of PML in an apparently immunocompetent patient treated with cidofovir.

Case Presentation

A 35-year-old immunocompetent man who developed progressive hemianopsia, aphasia, and limb weakness underwent repeated MRI scans of the brain, spinal fluid analyses, and brain biopsy. Before diagnosis was established based on brain biopsy, he was consecutively treated with methylprednisolone, acyclovir, ceftriaxone and plasmapheresis, but he deteriorated rapidly suggestive of the immune reconstitution inflammatory syndrome (IRIS). He started to recover two weeks after the initiation of treatment with cidofovir and has had no relapse at 3 1/2 years of follow-up. MRI has shown marked improvement.

Conclusions

PML should be considered in immunocompetent patients with a typical clinical course and MRI findings compatible with PML. Treatment with cidofovir should be considered as early as possible in the disease course.