Journal article
Successful Recovery from Meningoencephalitis Associated with Archetype-like JC Virus in a Lung Transplant Recipient: Case Report and Review of the Literature
Annals of clinical case reports, Vol.10(1), 2736
01/01/2025
PMCID: PMC13155386
PMID: 42111477
Abstract
Meningoencephalitis due to JC polyomavirus (JCV) is rare and delays in diagnosis could lead to potentially fatal outcomes in immunosuppressed patients. We present a case of an HIV-negative lung transplant recipient who presented with neurological deficits, including aphasia and right-sided weakness. Brain imaging lacked demyelination usually diagnostic of progressive multifocal leukoencephalopathy (PML), the disease most often associated with JC virus, however cerebrospinal fluid (CSF) metagenomic analysis confirmed a high JC viral load, suggestive of JCV-associated meningoencephalitis. After reducing immunosuppression, the patient showed significant neurological improvement within three months and full recovery by 6 months. The JCV genome sequenced from patient’s plasma and CSF were identical and resembled the “nonpathogenic” archetype in the non-coding region but shared homology in the coding region with the classically-considered neurotropic strains detected in those with PML. These findings suggest that mutations in the virus’s noncoding region are not necessary for neuropathogenesis. We also review other cases of JCV-associated meningitis and encephalitis, which, in contrast to our case, were all fatal. Clinicians should consider JCV testing in immunosuppressed patients with encephalopathy and focal neurological deficits, even in the absence of significant brain radiographic abnormalities.
Details
- Title: Subtitle
- Successful Recovery from Meningoencephalitis Associated with Archetype-like JC Virus in a Lung Transplant Recipient: Case Report and Review of the Literature
- Creators
- Julie C Gudenkauf - University of IowaElizabeth Wagstaff - Department of Neurology, University of Iowa, Iowa City, USA Department of Microbiology and Immunology, University of Iowa, Iowa City, USA Department of Internal Medicine, University of Iowa, Iowa City, USAErik J. Arneson - University of IowaChristine Gill - University of IowaAaron N. Gillman - University of IowaHillel Haim - University of IowaC. Sabrina Tan - University of Iowa
- Resource Type
- Journal article
- Publication Details
- Annals of clinical case reports, Vol.10(1), 2736
- PMID
- 42111477
- PMCID
- PMC13155386
- NLM abbreviation
- Ann Clin Case Rep
- eISSN
- 2474-1655
- Language
- English
- Date published
- 01/01/2025
- Academic Unit
- Neurology; Microbiology and Immunology; Infectious Diseases; Iowa Neuroscience Institute; Internal Medicine
- Record Identifier
- 9985161445802771
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