Purpose:

Progressive multifocal leukoencephalopathy (PML) is a lethal demyelinating disease of the central nervous system caused by John Cunningham virus (JCV). PML develops due to the reactivation of latent JCV infection in individuals with cellular immu­nodeficiency. Since the beginning of acquired immunodeficiency syndrome (AIDS) epidemic, human immunodeficiency virus (HIV) infection has remained a leading cause of PML with the condition recognized as an AIDS-defining illness. The clinical manifestations of PML may vary depending on the underlying condition. In AIDS-associated PML, the symptoms include motor weakness, speech or language disturbances, cognitive and behavioral changes and gait abnormalities and incoordination.

Case description:

We present the case of a male patient who developed PML as the first clinical manifestation of a newly diagnosed HIV infection.

Comment:

The introduction of antiretroviral therapy has led to a significant decrease in the morbidity and mortality due to the opportunistic infections in HIV-positive patients. However, the improvement is least pronounced in case of PML.