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A patient known HIV , he presented with altered mental state. These findings are non-specific, but in an HIV patient, PML is not excluded. The main differential diagnosis would be HIV encephalitis, CMV encephalitis, IRIS (Immune Reconstitution Inflammatory Syndrome), ADEM & multiple sclerosis. This case is atypical as the findings are not as extensive as expected in PML. The patient died a few months later. This patient had a prior brain biopsy which confirmed JC virus-infected oligodendrocytes
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