title: Rapid Multifocal Neurologic Decline in an Immunocompromised Patient.
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.
authors.affiliation: Division of Neurology, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada2Department of Critical Care Medicine, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Julie Anne
authors.initials: JA
authors.lastname: Kromm
authors.affiliation: Division of Neurology, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Christopher
authors.initials: C
authors.lastname: Power
authors.affiliation: Division of Neurology, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Gregg
authors.initials: G
authors.lastname: Blevins
authors.affiliation: Division of Hematology, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Loree
authors.initials: L
authors.lastname: Larratt
authors.affiliation: Neuropathology Specialty Group, Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: F K H
authors.initials: FK
authors.lastname: van Landeghem
authors.affiliation: Department of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Jeremy
authors.initials: J
authors.lastname: Rempel
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001921:Brain / Q000473:pathology*; D017809:Fatal Outcome; D006801:Humans; D016867:Immunocompromised Host; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D007968:Leukoencephalopathy, Progressive Multifocal / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D008297:Male