Rapid Multifocal Neurologic Decline in an Immunocompromised Patient.

Kromm, Julie Anne; Power, Christopher; Blevins, Gregg; Larratt, Loree; van Landeghem, F K H; Rempel, Jeremy · JAMA Neurol · 2016

case_report · Level V

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Abstract

A man in his early 70s with a diagnosis of chronic lymphocytic leukemia and being treated with prednisone, fludarabine, cyclophosphamide, and rituximab presented with progressive multifocal neurologic decline. The patient died 2 months after the onset of this decline despite extensive clinical and laboratory investigation and a trial of methylprednisolone therapy. The approach to the immunosuppressed patient with progressive neurologic decline, neuropathologic findings, and final diagnosis are discussed.

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