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Progressive multifocal leukoencephalopathy

Case contributed by Wael Alfehaid
Diagnosis almost certain

Presentation

No clear history. LAB test shows positive HIV.

Patient Data

Age: 30 years
Gender: Male

Multiple confluent areas of T2/FlAIR bright signal noted mainly involving bilateral frontoparietal and right temporal subcortical white matter with asymmetrical distribution, these areas show diffusion restriction. No enhancement was noted.

Case Discussion

Progressive multifocal leukoencephalopathy (PML) is a demyelinating disease of the central nervous system characterized by widespread lesions due to infection with John Cunningham virus (JC virus) infection. This type of demyelinating disease has strong association with immunosuppressed patient.

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