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CASE REPORT
Year : 2016  |  Volume : 8  |  Issue : 1  |  Page : 51-54

Progressive multifocal leukoencephalopathy in a lung transplant recipient: Isolation of John Cunningham (JC) virus from bronchoalveolar lavage


1 John and Doris Norton Thoracic Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ, USA
2 Department of Pulmonary Medicine, Respiratory Institute, Cleveland Clinic, Cleveland, OH, USA
3 Department of Infectious Diseases, Medicine Institute, Cleveland Clinic, Cleveland, OH, USA
4 Division of Thoracic Surgery and Interventional Pulmonology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA

Correspondence Address:
Atul C Mehta
Department of Pulmonary Medicine, Respiratory Institute, Cleveland Clinic, Cleveland, OH
USA
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0974-777X.176150

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Progressive multifocal leukoencephalopathy (PML) is a demyelinating disease of the central nervous system caused by polyomavirus John Cunningham (JC) virus. We report the case of a 60-year-old woman who presented 16 months after right single lung transplant with worsening memory, behavioral problems, emotional lability, and progressive left upper extremity weakness. Magnetic resonance imaging revealed white matter changes suggestive of PML. JC virus infection was confirmed with polymerase chain reaction (PCR) from both the bronchoalveolar lavage (BAL) fluid and cerebrospinal fluid. To our knowledge, this is the first report of PCR isolation of JC virus from a BAL specimen. We also review the two additional cases in the literature that describe PML after lung transplantation. JC virus infection should be considered in the differential diagnosis of lung transplant recipients who develop neurological symptoms. BAL may have a role in the etiologic diagnosis of PML after lung transplantation.


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2008 Journal of Global Infectious Diseases | Published by Wolters Kluwer - Medknow
Online since 10th December, 2008