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Case Reports
. 2017 Oct;23(5):789-792.
doi: 10.1007/s13365-017-0565-5. Epub 2017 Aug 22.

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

Fabian Sierra Morales  1   2 , Carlos Illingworth  3 , Kathie Lin  4 , Ivia Rivera Agosto  4 , Chloé Powell  4 , Jacob A Sloane  4 , Igor J Koralnik  5   6
Affiliations
Case Reports

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

Fabian Sierra Morales et al. J Neurovirol. 2017 Oct.

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.

Keywords: Bell’s palsy; HIV-2; Immune reconstitution inflammatory syndrome; JC virus; Progressive multifocal leukoencephalopathy.

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Conflict of interest statement

Conflict of Interest:

Fabian Sierra Morales, Carlos Illingworth, Kathie Lin, Ivia Rivera Agosto, Chloe Powell, Jacob A. Sloane, and Igor J. Koralnik declare that they have no conflict of interest.

Figures

Figure 1
Figure 1. MRI findings after symptom onset
MRI of left facial colliculus PML lesion 6 weeks after symptom onset. (A) Axial fluid-attenuated inversion recovery (FLAIR) image shows a lesion in the left facial colliculus (arrow). (B) Axial post-contrast T1 weighted images demonstrates faint peripheral enhancement in the lesion and hazy enhancement in the right pons (arrow) (the latter was compatible with a capillary telangiectasia that was unchanged from a study done 7 years prior to his current presentation). Sagittal and coronal post-contrast T1 weighted images (C and D) demonstrate faint peripheral enhancement in the lesion (arrows) of the left facial colliculus.
See this image and copyright information in PMC

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