West Nile virus encephalitis in a renal transplant recipient: the role of intravenous immunoglobulin.

West Nile virus is a common viral infection in endemic areas. Although the disease has a benign course in immunocompetent individuals, it tends to run a more malignant course in immunocompromised patients such as solid-organ transplant recipients. In this study, a renal transplant recipient presented with fever, impaired speech, obtundation, and features suggestive of meningitis on cerebrospinal fluid examination. Although initial serological study results were negative, the patient was treated promptly with intravenous immunoglobulin (IVIG) based on a strong clinical suspicion of West Nile virus encephalitis. Therapy with IVIG was associated with complete recovery of neurological features, and the patient was discharged on day 7 after resolution of neurological complications. The favorable outcome of this patient may be related to early treatment with IVIG.