INTRODUCTION: Estimates indicate that West Nile virus infects approximately one and a half million people in the United States of America. Up to 1% may develop West Nile virus neuroinvasive disease, in which infected patients develop any combination of meningitis, encephalitis, or acute paralysis. CASE PRESENTATION: A 56-year-old African-American man presented to our hospital with headache, restlessness, fever, myalgias, decreased appetite, and progressive confusion. A cerebrospinal fluid examination showed mild leukocytosis and an elevated protein level. Testing for routine infections was negative. Brain T2-weighted magnetic resonance imaging scans showed marked enlargement of caudate nuclei and increased intensity within the basal ganglia and thalami. A West Nile virus titer was positive, and serial brain magnetic resonance imaging scans showed resolving abnormalities that paralleled his neurological examination. CONCLUSION: This report is unusual as it portrays the natural history and long-term consequences of West Nile virus meningoencephalitis diagnosed on the basis of serial brain images.
INTRODUCTION: Estimates indicate that West Nile virus infects approximately one and a half million people in the United States of America. Up to 1% may develop West Nile virus neuroinvasive disease, in which infectedpatients develop any combination of meningitis, encephalitis, or acute paralysis. CASE PRESENTATION: A 56-year-old African-American man presented to our hospital with headache, restlessness, fever, myalgias, decreased appetite, and progressive confusion. A cerebrospinal fluid examination showed mild leukocytosis and an elevated protein level. Testing for routine infections was negative. Brain T2-weighted magnetic resonance imaging scans showed marked enlargement of caudate nuclei and increased intensity within the basal ganglia and thalami. A West Nile virus titer was positive, and serial brain magnetic resonance imaging scans showed resolving abnormalities that paralleled his neurological examination. CONCLUSION: This report is unusual as it portrays the natural history and long-term consequences of West Nile virus meningoencephalitis diagnosed on the basis of serial brain images.
Authors: D Nash; F Mostashari; A Fine; J Miller; D O'Leary; K Murray; A Huang; A Rosenberg; A Greenberg; M Sherman; S Wong; M Layton Journal: N Engl J Med Date: 2001-06-14 Impact factor: 91.245
Authors: Larry E Davis; Roberta DeBiasi; Diane E Goade; Kathleen Y Haaland; Jennifer A Harrington; JoAnn B Harnar; Steven A Pergam; Molly K King; B K DeMasters; Kenneth L Tyler Journal: Ann Neurol Date: 2006-09 Impact factor: 10.422
Authors: Kristy Murray; Christopher Walker; Emily Herrington; Jessica A Lewis; Joseph McCormick; David W C Beasley; Robert B Tesh; Susan Fisher-Hoch Journal: J Infect Dis Date: 2010-01-01 Impact factor: 5.226