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

BMC Neurol. 2024 May 4;24(1):151. doi: 10.1186/s12883-024-03650-y.

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.

Keywords: B-CLL; COVID-19; Mucormycosis; PML.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • COVID-19 Vaccines* / adverse effects
  • COVID-19* / complications
  • Humans
  • Immunocompromised Host
  • Leukemia, Lymphocytic, Chronic, B-Cell* / complications
  • Leukoencephalopathy, Progressive Multifocal* / diagnosis
  • Leukoencephalopathy, Progressive Multifocal* / etiology
  • Male
  • Mucormycosis* / complications