Progressive multifocal leukoencephalopathy in a patient with B-cell chronic lymphocytic leukemia after Covid 19 vaccination, complicated with Covid-19 and mucormycosis: a case report (preprint)

Background: Progressive multifocal leukoencephalopathy (PML) is an opportunistic viral demyelinating infectious disease of the central nervous system (CNS) which is rare & fetal. There is various clinical presenting symptoms for the disease. Case presentation: This paper presents a clinical case of PML in a patient with B-CLL in remission, previously treated with Chlorambucil that complicated later in disease course with Covid-19 and mucormycosis. Conclusion: like many other viruses, the more relevant immune-competent cells in host defense against JCV, appear to be T cells. This issue is recently also suggested in Covid 19 patients which a dissociation between severity and seroconversion has been reported. The case reported due to its rarity and multiple challenges in its diagnosis and treatment.

Acute disseminated encephalomyelitis following inactivated COVID-19 vaccine: A case report (preprint)

Background Neurological involvement including CNS demyelination syndromes following SARS-CoV-2 infection have been reported as extra-pulmonary involvement in patients with COVID-19. Besides, immune-mediated central nervous system involvement is a rare phenomenon that is considered to be one of the most important and serious complications of vaccines as well. While regarding the recent pandemic and worldwide use of the COVID-19 vaccines investigating serious life-threatening side effects is worth considering.Case presentation: This article reported a young male Iranian patient without any past medical history and neurological problems who presented acute disorientation due to acute central nervous system demyelination approximately one month after receiving the first dosage of Sinopharm BIBP COVID-19 vaccine. Based on extended clinical investigations the patient had undergone the treatment with the highly probable diagnosis of acute disseminated encephalomyelitis syndrome.Conclusion In this article clinical presentation, diagnosis, and treatment of the patient with the diagnosis of ADEM following COVID-19 vaccine administration have been discussed. It seems for timely diagnosis and access to a safer state in our global immunization, reporting and evaluating the diagnosis approach and challenges in treatment and patient recovery regarding rare and adverse effects is worth considering.