Progressive multifocal leukoencephalopathy in a patient with B-cell chronic lymphocytic leukemia after COVID-19 vaccination, complicated with COVID-19 and mucormycosis: a case report
Hamed Amirifard,
Mojtaba Shahbazi,
Ghasem Farahmand,
Zahra Ranjbar,
Maryam Kaeedi,
Sanaz Heydari Havadaragh
Affiliations
Hamed Amirifard
Iranian Center of Neurological Research, Neuroscience Institute, Tehran University of Medical Sciences
Mojtaba Shahbazi
Iranian Center of Neurological Research, Neuroscience Institute, Tehran University of Medical Sciences
Ghasem Farahmand
Iranian Center of Neurological Research, Neuroscience Institute, Tehran University of Medical Sciences
Zahra Ranjbar
Iranian Center of Neurological Research, Neuroscience Institute, Tehran University of Medical Sciences
Maryam Kaeedi
Iranian Center of Neurological Research, Neuroscience Institute, Tehran University of Medical Sciences
Sanaz Heydari Havadaragh
Iranian Center of Neurological Research, Neuroscience Institute, Tehran University of Medical Sciences
Abstract Background Progressive multifocal leukoencephalopathy (PML) is a rare and fatal opportunistic viral demyelinating infectious disease of the central nervous system (CNS). There are various clinical presenting symptoms for the disease. Case presentation This paper presents a clinical case of PML in a patient with B-Chronic lymphocytic leukemia (B-CLL), previously treated with Chlorambucil, later complicated later with COVID-19 and mucormycosis. Conclusion PML can develop in the setting of cellular immune dysfunction. Late diagnosis of this disease based on nonspecific symptoms is common, therefore when we face a neurological complication in a CLL or immunocompromised patient, we should consider PML infection. A remarkable feature of this case is the possible triggering effect of COVID-19 vaccination for emergence of PML as the disease can be asymptomatic or sub-clinical before diagnosis.
