The natural history of West Nile virus infection presenting with West Nile virus meningoencephalitis in a man with a prolonged illness: a case report

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. A 56-year-old A...

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Bibliographic Details
Published in:	Journal of medical case reports 2011-05, Vol.5 (1), p.204-204, Article 204
Main Authors:	Mainali, Shraddha, Afshani, Mansoor, Wood, James B, Levin, Michael C
Format:	Article
Language:	eng
Subjects:	Case Report Case studies CT imaging Development and progression Diagnosis Meningoencephalitis Risk factors West Nile fever
Online Access:	Get full text
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Summary:	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. 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. 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.
ISSN:	1752-1947 1752-1947