# Unveiling the Enigma: John Cunningham Virus-Associated Progressive Multifocal Leukoencephalopathy in an Immunocompetent Individual

## TL;DR

This paper reports a rare case of PML in an immunocompetent person, highlighting the need for early diagnosis and treatment.

## Contribution

The novelty lies in documenting PML in an individual with a healthy immune system.

## Key findings

- PML was diagnosed in an immunocompetent patient presenting with stroke-like symptoms.
- Treatment with mefloquine and anti-malarial drugs was attempted but had an unfavorable outcome.
- The case underscores the importance of considering PML in differential diagnoses despite immune status.

## Abstract

Progressive multifocal leukoencephalopathy (PML) is considered an often fatal, demon-leading disease primarily associated with immunosuppression. Immunocompromised individuals predominantly exhibit this manifestation, while immunocompatible patients rarely encounter it. We present a unique case of PML in an immunocompetent individual who initially presented with stroke-like symptoms, received management, and was subsequently discharged. He returned to our hospital a few days later with similar complaints, prompting further investigations that revealed PML, a condition often overlooked, especially in individuals with an intact immune system. Although he received successful treatment with mefloquine and other anti-malarial medications and followed up on an outpatient basis, his subsequent outcome was unfavourable. As a result, this case emphasises the importance of having PML as a significant differential and therapeutic option.