- •This case illustrates rapid improvement in PML following bacterial pyelonephritis.
- •Clinical recovery was accompanied by marked reduction in PCR titer of JCV in CSF.
- •Increased urinary viral load associated with pyelonephritis at the site of latent JCV.
- •The immune response to JCV might be triggered by bacterial pyelonephritis.
Progressive multifocal leukoencephalopathy (PML) is caused by John Cunningham (JC) virus in immunocompromized patients such as those with human immunodeficiency virus (HIV) infection, hematological malignancy, autoimmune disorder, and immunodeficiency disorder as well as those undergoing chemotherapy or immunosuppressive therapy. No effective treatments have been established for PML, which commonly causes severe neurological sequelae. We describe the first case of PML in a patient without HIV infection who exhibited remarkable improvement following acute pyelonephritis with Escherichia coli bacteremia.
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- Progressive multifocal leukoencephalopathy in HIV-uninfected individuals.Curr Infect Dis Rep. 2016; 18: 33https://doi.org/10.1007/s11908-016-0543-8
- Immune system involvement in the pathogenesis of JC virus induced PML: what is learned from studies of patients with underlying diseases and therapies as risk factors.Front Immunol. 2015; 6: 159https://doi.org/10.3389/fimmu.2015.00159
- Persistence and pathogenesis of the neurotropic polyomavirus JC.Ann Neurol. 2015; 77: 560-570https://doi.org/10.1002/ana.24371
- A study of mefloquine treatment for progressive multifocal leukoencephalopathy: results and exploration of predictors of PML outcomes.J Neurovirol. 2013; 19: 351-358https://doi.org/10.1007/s13365-013-0173-y
- Mirtazapine use in human immunodeficiency virus-infected patients with progressive multifocal leukoencephalopathy.Arch Neurol. 2009; 66: 255-258https://doi.org/10.1001/archneurol.2008.557
- IgM predominance in autoimmune disease: genetics and gender.Autoimmun Rev. 2012; : A404-A412https://doi.org/10.1016/j.autrev.2011.12.001
- JC virus DNA load in patients with and without progressive multifocal leukoencephalopathy.Neurology. 1999; 52: 253-260https://doi.org/10.1212/WNL.52.2.253
- JC virus quasispecies analysis reveals a complex viral population underlying progressive multifocal leukoencephalopathy and supports viral dissemination via the hematogenous route.J Virol. 2015; 89: 1340-1347https://doi.org/10.1128/JVI.02565-14
- The innate immune response during urinary tract infection and pyelonephritis.Pediatr Nephrol. 2014; 29: 1139-1149https://doi.org/10.1007/s00467-013-2513-9
- Progressive Multifocal Leukoencephalopathy Consortium. Progressive multifocal leukoencephalopathy: current treatment options and future perspectives.Ther Adv Neurol Disord. 2015; 8: 255-273https://doi.org/10.1177/1756285615602832
Published online: January 03, 2019
Accepted: December 23, 2018
Received: November 10, 2018
© 2018 Elsevier Ltd. All rights reserved.