Progressive multifocal leukoencephalopathy (PML) is a rare demyelinating disease of the central nervous system caused by JC virus (JCV) and is difficult to diagnose. We report on a male HIV-positive patient with PML finally diagnosed by 3 times lumbar punctures and 2 times brain biopsies. Negative results of JCV-PCR in cerebrospinal fluid (CSF) do not rule out the diagnosis of PML when clinical manifestations and neuroimaging features suspected PML. It is necessary to obtain new CSF and make repeat tests and even perform brain biopsy.

中文翻译：

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通过 3 次腰椎穿刺和 2 次脑活检诊断出 HIV 患者的进行性多灶性白质脑病。

进行性多灶性白质脑病 (PML) 是一种罕见的由 JC 病毒 (JCV) 引起的中枢神经系统脱髓鞘疾病，诊断难度较大。我们报告了一名男性 HIV 阳性 PML 患者，最终通过 3 次腰椎穿刺和 2 次脑活检确诊。当临床表现和神经影像学特征怀疑 PML 时，脑脊液 (CSF) 中 JCV-PCR 的阴性结果不排除 PML 的诊断。有必要获得新的CSF并进行重复测试，甚至进行脑活检。