{
  "abstract": "Abstract Progressive multifocal leukoencephalopathy (PML) is an infectious disease of the central nervous system that is typically severe and classically occurs in the setting of overt immunocompromise. It is caused by the John Cunningham virus (JCV), a ubiquitous polyomavirus that only rarely leads to neurological complications. Prompt diagnosis of PML is essential for patient management, but can be complicated by disease development in individuals who are relatively immunocompetent, the lack of highly specific clinical symptoms, unfamiliarity with recently described neuroimaging signs and the imperfect sensitivity of assays used to detect JCV in cerebrospinal fluid (CSF). We review the supportive clinical features, neuroimaging findings and confirmatory testing for PML and propose an algorithm to facilitate accurate diagnosis in clinical practice.",
  "authors": [
    {
      "affiliations": [
        "Department of Medicine, Division of Neurology, University of Toronto, Toronto, Ontario, Canada"
      ],
      "name": "Katherine M Sawicka"
    },
    {
      "affiliations": [
        "Department of Pathology and Laboratory Medicine, Western University, London, Ontario, Canada",
        "London Health Sciences Centre, London, Ontario, Canada"
      ],
      "name": "Jacob Houpt"
    },
    {
      "affiliations": [
        "London Health Sciences Centre, London, Ontario, Canada",
        "Department of Clinical Neurological Sciences, Western University, London, Ontario, Canada"
      ],
      "name": "Kamala Sangam"
    },
    {
      "affiliations": [
        "National Microbiology Laboratory Branch, Public Health Agency of Canada, Winnipeg, Manitoba, Canada",
        "Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, Manitoba, Canada"
      ],
      "name": "Aida Sivro"
    },
    {
      "affiliations": [
        "National Microbiology Laboratory Branch, Public Health Agency of Canada, Winnipeg, Manitoba, Canada"
      ],
      "name": "Felicia Roy"
    },
    {
      "affiliations": [
        "London Health Sciences Centre, London, Ontario, Canada",
        "Department of Medical Imaging and Department of Clinical Neurological Sciences, Western University, London, Ontario, Canada"
      ],
      "name": "Manas Sharma"
    },
    {
      "affiliations": [
        "London Health Sciences Centre, London, Ontario, Canada",
        "Department of Medicine, Division of Infectious Diseases, Western University, London, Ontario, Canada"
      ],
      "name": "Michael Silverman"
    },
    {
      "affiliations": [
        "London Health Sciences Centre, London, Ontario, Canada",
        "Department of Pathology and Laboratory Medicine and Department of Clinical Neurological Sciences, Western University, London, Ontario, Canada"
      ],
      "name": "Robert Hammond"
    },
    {
      "affiliations": [
        "London Health Sciences Centre, London, Ontario, Canada",
        "Department of Clinical Neurological Sciences and Department of Pathology and Laboratory Medicine, Western University, London, Ontario, Canada"
      ],
      "name": "Adrian Budhram"
    }
  ],
  "title": "Diagnosing progressive multifocal leukoencephalopathy: clinical features, neuroimaging findings, confirmatory testing and proposed diagnostic algorithm",
  "uid": "edb2d225-4585-5617-b247-bbee54b500e7"
}