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Presumptive Jamestown Canyon viral retinitis
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  • Published on:
    Presumptive JC viral retinitis
    • Mahiul M Muqit, Consultant Vitreoretinal Surgeon Moorfields Eye Hospital
    • Other Contributors:
      • Baljean Dhillon, Professor of Clinical Ophthalmology

    Thank you for raising the issue of abbreviations entering the virological lexicon which might give rise to confusion and misunderstanding. Over a decade has elapsed since our patient report was published and the source material is not retrievable. However, our recollection is the patient was discussed contemporaneously at the MDT and the viral aetiology, radiology findings and medical management determined and documented, from which the data was sourced for the 2008 report. Plausible as it may seem, it is not possible to test the veracity of the suggestion that the names ‘Jamestown Canyon’ and ‘John Cunningham’ might have been transposed during that MDT many years after the event, paper records are not kept indefinitely in NHS practice and ethics in medical publishing demands that patient identifiers are not described or retained in order to preserve anonymity. Perhaps the latter should have been considered over half a century ago when JC virus was first identified in the brain of the unfortunate patient after whom the eponymous pathogen was christened
    (Padgett BL, Walker DL; et al. (1971). "Cultivation of papova-like virus from human brain with progressive multifocal leucoencephalopathy". Lancet. 1 (7712):
    1257–60. doi:10.1016/S0140-6736(71)91777-6)
     

    Conflict of Interest:
    None declared.
  • Published on:
    Beware of abbreviations: John Cunningham (JC) versus Jamestown Canyon virus
    • Elizabeth Matthews, Neuro-Infectious Diseases Fellow University of Colorado School of Medicine
    • Other Contributors:
      • Kenneth L Tyler, Professor of Neurology, Medicine, and Immunology-Microbiology
      • Victoria S Pelak, Professor of Neurology and Ophthalmology
      • Daniel M Pastula, Associate Professor of Neurology, Medicine, and Epidemiology

    In their 2008 case report, Muqit, et al. describe a case of “presumptive Jamestown Canyon viral retinitis.”1

    Jamestown Canyon virus is a mosquito-borne, single-stranded, ribonucleic acid (RNA) orthobunyavirus that is endemic throughout much of North America.2,3 Infection with Jamestown Canyon virus may be asymptomatic or may result in a general febrile illness, meningitis, and/or meningoencephalitis.2,3 Beyond the above case report by Muqit, et al.,1 and another review article referencing this case report,4 Jamestown Canyon virus has not been reported to cause retinitis or other ocular manifestations.

    Upon close review of the case report by Muqit, et al.,1 we believe the authors are likely describing a case of John Cunningham (JC) virus (a ubiquitous, double-stranded, deoxyribonucleic acid [DNA] human polyomavirus known to cause progressive multifocal leukoencephalopathy [PML] among the immunocompromised)5-7 rather than Jamestown Canyon virus.

    First, the case patient with viral retinitis had underlying human immunodeficiency virus (HIV) infection and a low CD4 lymphocyte count (240 cells/mm3), making him immunocompromised and susceptible to reactivation of the John Cunningham (JC) virus. Second, the case patient had magnetic resonance imaging (MRI) brain findings (i.e., asymmetric, predominantly posterior, confluent, subcortical white matter hyperintensities involving U-fibers) that are classic for John Cunningham (JC) virus-related PML.6,7 In fact,...

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    Conflict of Interest:
    None declared.