Hardinger Karen L, Miller Brent, Storch Gregory A, Desai Niraj M, Brennan Daniel C
Pharmacy, Barnes-Jewish Hospital, Washington University, St Louis, MO, USA.
Am J Transplant. 2003 Oct;3(10):1312-5. doi: 10.1046/j.1600-6143.2003.00223.x.
West Nile virus is a mosquito-borne, single-stranded RNA virus of the Flaviviridae family. Approximately 1 in 150 patients who have serologic evidence of West Nile virus infection develop encephalitis or meningitis. We report two chronically immunosuppressed renal transplant recipients with confirmed West Nile virus meningoencephalitis acquired through community exposure. Both patients presented with fever and neurological changes in the autumn of 2002. Flavivirus-specific immunoglobulin M in antibodies in the cerebral spinal fluid and serum were detected by antibody-capture enzyme immunoassay, and antibodies for West Nile virus were confirmed by the plaque neutralization reduction assay. Reduction in immunosuppression and supportive care were successful in treating both patients. West Nile meningoencephalitis should be considered in transplant recipients that present with signs and symptoms of meningoencephalitis.
西尼罗河病毒是一种由蚊子传播的黄病毒科单链RNA病毒。约150名有西尼罗河病毒感染血清学证据的患者中，有1人会发展为脑炎或脑膜炎。我们报告了两名经社区接触确诊感染西尼罗河病毒脑膜脑炎的慢性免疫抑制肾移植受者。两名患者均于2002年秋季出现发热和神经学改变。通过抗体捕获酶免疫测定法检测脑脊液和血清中黄病毒特异性免疫球蛋白M抗体，并通过蚀斑中和减少试验确认西尼罗河病毒抗体。减少免疫抑制并给予支持治疗成功治愈了两名患者。对于出现脑膜脑炎体征和症状的移植受者，应考虑西尼罗河病毒脑膜脑炎。
