Skip to main content

Advertisement

SpringerLink
Log in

PML-IRIS in an HIV-2-infected patient presenting as Bell’s palsy

  • Case Report
  • Published:
Journal of NeuroVirology Aims and scope Submit manuscript

Abstract

We present the case of an HIV-2-infected patient who developed progressive multifocal leukoencephalopathy (PML) in the setting of immune reconstitution inflammatory syndrome (IRIS) presenting as Bell’s palsy. The brain MRI showed a single lesion in the facial colliculus considered initially to be ischemic in nature. This case report should alert clinicians that PML can occur in the setting of HIV-2 infection. It also illustrates the difficulty of establishing the diagnosis of PML.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  • Berger JR, Aksamit AJ, Clifford DB, Davis L, Koralnik IJ, Sejvar JJ, Bartt R, Major EO, Nath A (2013) PML diagnostic criteria: consensus statement from the AAN Neuroinfectious Disease Section. Neurology 80(15):1430–1438

    Article  PubMed  PubMed Central  Google Scholar 

  • Bienaime A, Colson P, Moreau J, Zandotti C, Pellissier JF, Brouqui P (2006) Progressive multifocal leukoencephalopathy in HIV-2-infected patient. AIDS 20(9):1342–1343

    Article  PubMed  Google Scholar 

  • Campbell-Yesufu OT, Gandhi RT (2011) Update on human immunodeficiency virus (HIV)-2 infection. Clin Infect Dis 52(6):780–787

    Article  PubMed  PubMed Central  Google Scholar 

  • Chan PA, Wakeman SE, Flanigan T, Cu-Uvin S, Kojic E, Kantor R (2008) HIV-2 diagnosis and quantification in high-risk patients. AIDS Res Ther 5:18

    Article  PubMed  PubMed Central  Google Scholar 

  • Choi Y, Townend J, Vincent T, Zaidi I, Sarge-Njie R, Jaye A, Clifford DB (2011) Neurologic manifestations of human immunodeficiency virus-2: dementia, myelopathy, and neuropathy in West Africa. J Neuro-Oncol 17(2):166–175

    Google Scholar 

  • Descamps D, Peytavin G, Visseaux B, Tubiana R, Damond F, Campa P, Charpentier C, Khuong-Josses MA, Duvivier C, Karmochkine M, Lukiana T, Matheron S (2015) Dolutegravir in HIV-2-infected patients with resistant virus to first-line integrase inhibitors from the French named patient program. Clin Infect Dis 60(10):1521–1527

    PubMed  Google Scholar 

  • Duque V, Matos AM, da Cunha JS, Melico-Sivestre A (2010) Progressive multifocal leukoencephalopathy in HIV-2 infection. Case report. J Clin Virol 48(3):215–217

    Article  PubMed  Google Scholar 

  • Gheuens S, Ngo L, Wang X, Alsop DC, Lenkinski RE, Koralnik IJ (2012) Metabolic profile of PML lesions in patients with and without IRIS: an observational study. Neurology 79(10):1041–1048

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Lucas SB, Hounnou A, Peacock C, Beaumel A, Djomand G, N'Gbichi JM, Yeboue K, Honde M, Diomande M, Giordano C et al (1993) The mortality and pathology of HIV infection in a west African city. AIDS 7(12):1569–1579

    Article  CAS  PubMed  Google Scholar 

  • Miskin DP, Ngo LH, Koralnik IJ (2016) Diagnostic delay in progressive multifocal leukoencephalopathy. Ann Clin Transl Neurol 3(5):386–391

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Moulignier A, Lascoux C, Bourgarit A (2006) HIV type 2 demyelinating encephalomyelitis. Clin Infect Dis 42(11):e89–e91

    Article  PubMed  Google Scholar 

  • Nath A (2015) Neurologic complications of human immunodeficiency virus infection. Continuum (Minneap Minn) 21(6 Neuroinfectious Disease):1557–1576

    Google Scholar 

  • Nyamweya S, Hegedus A, Jaye A, Rowland-Jones S, Flanagan KL, Macallan DC (2013) Comparing HIV-1 and HIV-2 infection: lessons for viral immunopathogenesis. Rev Med Virol 23(4):221–240

    Article  CAS  PubMed  Google Scholar 

  • Sierra MF, Illingworth C, Lin K, Rivera Agosto I, Powell C, Sloane JA, Koralnik IJ (2017) PMLIRIS in an HIV-2-infected patient presenting as Bell’s palsy. J Neurovirol

  • Stoner GL, Agostini HT, Ryschkewitsch CF, Mazlo M, Gullotta F, Wamukota W, Lucas S (1998) Detection of JC virus in two African cases of progressive multifocal leukoencephalopathy including identification of JCV type 3 in a Gambian AIDS patient. J Med Microbiol 47(8):733–742

    Article  CAS  PubMed  Google Scholar 

  • Wang H, Wolock TM, Carter A, Nguyen G, Kyu HH, Gakidou E, Hay SI, Mills EJ, Trickey A, Msemburi W, Coates MM, Mooney MD, Fraser MS, Sligar A, Salomon J, Larson HJ, Friedman J, Abajobir AA, Abate KH, Abbas KM, Razek MM, Abd-Allah F, Abdulle AM, Abera SF, Abubakar I, Abu-Raddad LJ, Abu-Rmeileh NM, Abyu GY, Adebiyi AO, Adedeji IA, Adelekan AL, Adofo K, Adou AK, Ajala ON, Akinyemiju TF, Akseer N, Lami FH, Al-Aly Z, Alam K, Alam NK, Alasfoor D, Aldhahri SF, Aldridge RW, Alegretti MA, Aleman AV, Alemu ZA, Alfonso-Cristancho R, Ali R, Alkerwi A, Alla F, Mohammad R, Al-Raddadi S, Alsharif U, Alvarez E, Alvis-Guzman N, Amare AT, Amberbir A, Amegah AK, Ammar W, Amrock SM, Antonio CA, Anwari P, Arnlov J, Artaman A, Asayesh H, Asghar RJ, Assadi R, Atique S, Atkins LS, Avokpaho EF, Awasthi A, Quintanilla BP, Bacha U, Badawi A, Barac A, Barnighausen T, Basu A, Bayou TA, Bayou YT, Bazargan-Hejazi S, Beardsley J, Bedi N, Bennett DA, Bensenor IM, Betsu BD, Beyene AS, Bhatia E, Bhutta ZA, Biadgilign S, Bikbov B, Birlik SM, Bisanzio D, Brainin M, Brazinova A, Breitborde NJ, Brown A, Burch M, Butt ZA, Campuzano JC, Cardenas R, Carrero JJ, Castaneda-Orjuela CA, Rivas JC, Catala-Lopez F, Chang HY, Chang JC, Chavan L, Chen W, Chiang PP, Chibalabala M, Chisumpa VH, Choi JY, Christopher DJ, Ciobanu LG, Cooper C, Dahiru T, Damtew SA, Dandona L, Dandona R, das Neves J, de Jager P, De Leo D, Degenhardt L, Dellavalle RP, Deribe K, Deribew A, Des Jarlais DC, Dharmaratne SD, Ding EL, Doshi PP, Driscoll TR, Dubey M, Elshrek YM, Elyazar I, Endries AY, Ermakov SP, Eshrati B, Esteghamati A, Faghmous ID, Farinha CS, Faro A, Farvid MS, Farzadfar F, Fereshtehnejad SM, Fernandes JC, Fischer F, Fitchett JR, Foigt N, Fullman N, Furst T, Gankpe FG, Gebre T, Gebremedhin AT, Gebru AA, Geleijnse JM, Gessner BD, Gething PW, Ghiwot TT, Giroud M, Gishu MD, Glaser E, Goenka S, Goodridge A, Gopalani SV, Goto A, Gugnani HC, Guimaraes MD, Gupta R, Gupta R, Gupta V, Haagsma J, Hafezi-Nejad N, Hagan H, Hailu GB, Hamadeh RR, Hamidi S, Hammami M, Hankey GJ, Hao Y, Harb HL, Harikrishnan S, Haro JM, Harun KM, Havmoeller R, Hedayati MT, Heredia-Pi IB, Hoek HW, Horino M, Horita N, Hosgood HD, Hoy DG, Hsairi M, Hu G, Huang H, Huang JJ, Iburg KM, Idrisov BT, Innos K, Iyer VJ, Jacobsen KH, Jahanmehr N, Jakovljevic MB, Javanbakht M, Jayatilleke AU, Jeemon P, Jha V, Jiang G, Jiang Y, Jibat T, Jonas JB, Kabir Z, Kamal R, Kan H, Karch A, Karema CK, Karletsos D, Kasaeian A, Kaul A, Kawakami N, Kayibanda JF, Keiyoro PN, Kemp AH, Kengne AP, Kesavachandran CN, Khader YS, Khalil I, Khan AR, Khan EA, Khang YH, Khubchandani J, Kim YJ, Kinfu Y, Kivipelto M, Kokubo Y, Kosen S, Koul PA, Koyanagi A, Defo BK, Bicer BK, Kulkarni VS, Kumar GA, Lal DK, Lam H, Lam JO, Langan SM, Lansingh VC, Larsson A, Leigh J, Leung R, Li Y, Lim SS, Lipshultz SE, Liu S, Lloyd BK, Logroscino G, Lotufo PA, Lunevicius R, Razek HM, Mahdavi M, Majdan M, Majeed A, Makhlouf C, Malekzadeh R, Mapoma CC, Marcenes W, Martinez-Raga J, Marzan MB, Masiye F, Mason-Jones AJ, Mayosi BM, McKee M, Meaney PA, Mehndiratta MM, Mekonnen AB, Melaku YA, Memiah P, Memish ZA, Mendoza W, Meretoja A, Meretoja TJ, Mhimbira FA, Miller TR, Mikesell J, Mirarefin M, Mohammad KA, Mohammed S, Mokdad AH, Monasta L, Moradi-Lakeh M, Mori R, Mueller UO, Murimira B, Murthy GV, Naheed A, Naldi L, Nangia V, Nash D, Nawaz H, Nejjari C, Ngalesoni FN, de Dieu Ngirabega J, Nguyen QL, Nisar MI, Norheim OF, Norman RE, Nyakarahuka L, Ogbo FA, Oh IH, Ojelabi FA, Olusanya BO, Olusanya JO, Opio JN, Oren E, Ota E, Padukudru MA, Park HY, Park JH, Patil ST, Patten SB, Paul VK, Pearson K, Peprah EK, Pereira CC, Perico N, Pesudovs K, Petzold M, Phillips MR, Pillay JD, Plass D, Polinder S, Pourmalek F, Prokop DM, Qorbani M, Rafay A, Rahimi K, Rahimi-Movaghar V, Rahman M, Rahman MH, Rahman SU, Rai RK, Rajsic S, Ram U, Rana SM, Rao PV, Remuzzi G, Rojas-Rueda D, Ronfani L, Roshandel G, Roy A, Ruhago GM, Saeedi MY, Sagar R, Saleh MM, Sanabria JR, Santos IS, Sarmiento-Suarez R, Sartorius B, Sawhney M, Schutte AE, Schwebel DC, Seedat S, Sepanlou SG, Servan-Mori EE, Shaikh MA, Sharma R, She J, Sheikhbahaei S, Shen J, Shibuya K, Shin HH, Sigfusdottir ID, Silpakit N, Silva DA, Silveira DG, Simard EP, Sindi S, Singh JA, Singh OP, Singh PK, Skirbekk V, Sliwa K, Soneji S, Sorensen RJ, Soriano JB, Soti DO, Sreeramareddy CT, Stathopoulou V, Steel N, Sunguya BF, Swaminathan S, Sykes BL, Tabares-Seisdedos R, Talongwa RT, Tavakkoli M, Taye B, Tedla BA, Tekle T, Shifa GT, Temesgen AM, Terkawi AS, Tesfay FH, Tessema GA, Thapa K, Thomson AJ, Thorne-Lyman AL, Tobe-Gai R, Topor-Madry R, Towbin JA, Tran BX, Dimbuene ZT, Tsilimparis N, Tura AK, Ukwaja KN, Uneke CJ, Uthman OA, Venketasubramanian N, Vladimirov SK, Vlassov VV, Vollset SE, Wang L, Weiderpass E, Weintraub RG, Werdecker A, Westerman R, Wijeratne T, Wilkinson JD, Wiysonge CS, Wolfe CD, Won S, Wong JQ, Xu G, Yadav AK, Yakob B, Yalew AZ, Yano Y, Yaseri M, Yebyo HG, Yip P, Yonemoto N, Yoon SJ, Younis MZ, Yu C, Yu S, Zaidi Z, Zaki Mel S, Zeeb H, Zhang H, Zhao Y, Zodpey S, Zoeckler L, Zuhlke LJ, Lopez AD, Murray CJ (2016) Estimates of global, regional, and national incidence, prevalence, and mortality of HIV, 1980-2015: the Global Burden of Disease Study 2015. Lancet HIV 3(8):e361–e387

    Article  Google Scholar 

Download references

Acknowledgements

This work was supported in part by grants NIH R01 NS 047029 and R01 NS 074995 to IJK.

Author information

Authors and Affiliations

  1. Section of Neuro-Infectious Diseases, Rush University Medical Center, 1725 W. Harrison Street, Suite 1106, Chicago, IL, 60612, USA

    Fabian Sierra Morales & Igor J. Koralnik

  2. Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA

    Fabian Sierra Morales & Igor J. Koralnik

  3. Department of Neurology, Hahnemann University Hospital, Philadelphia, PA, USA

    Carlos Illingworth

  4. Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, USA

    Kathie Lin, Ivia Rivera Agosto, Chloé Powell & Jacob A. Sloane

Authors
  1. Fabian Sierra Morales
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Carlos Illingworth
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Kathie Lin
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Ivia Rivera Agosto
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Chloé Powell
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Jacob A. Sloane
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Igor J. Koralnik
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Igor J. Koralnik.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Sierra Morales, F., Illingworth, C., Lin, K. et al. PML-IRIS in an HIV-2-infected patient presenting as Bell’s palsy. J. Neurovirol. 23, 789–792 (2017). https://doi.org/10.1007/s13365-017-0565-5

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13365-017-0565-5

Keywords

Search

Navigation