A 36 year old man with untreated HIV infection develops progressive visual changes, weakness, and difficulty speaking over several weeks. MRI of the brain shows multiple asymmetric nonenhancing white matter lesions without mass effect. Cerebrospinal fluid polymerase chain reaction is positive for JC virus. Which of the following is the most likely diagnosis?
- A)Toxoplasmosis
- B)Subacute sclerosing panencephalitis
- C)Primary CNS lymphoma
- D)Creutzfeldt Jakob disease
- E)Progressive multifocal leukoencephalopathyGABARITO
Explicação
JC virus reactivation in immunosuppressed patients causes progressive multifocal leukoencephalopathy, a demyelinating disease of oligodendrocytes. The multifocal nonenhancing white matter lesions without mass effect are highly characteristic. Ver explicação completa e trilha adaptativa →