Sević Sinisa, Stefan-Mikić Sandra, Sipovac Dragana, Turkulov Vesna, Milosević Vesna, Hrnjaković-Cvjetković Ivana
Vojnosanit Pregl. 2015 Dec;72(12):1098-104. doi: 10.2298/vsp140718115s.
BACKGROUND/AIM: West Nile virus (WNV) is a neurotropic RNA virus particle which belongs to the Flaviviidae family, genus Flavivirus. It is sustained in arthropods within the transmission cycle between the mosquitoes and birds. Most commonly (80% of cases) WNV infections are asymptomatic among people. Less than 1% of patients develop neuroinvasive forms of the disease--meningitis, encephalitis, or acute flaccid paralysis. The aim of the research was to determine most common clinical and laboratory manifestations, to emphazise the presence of comorbidities and outcomes of treatment among patients with WNV infection.
This retrospective study, which was conducted in the period from January 1, 2012 to December 31, 2013, evaluated 32 patients who were diagnosed with WNV infection based on clinical findings, laboratory, and serological tests. To assess statistical significance we used χ2, and t-test.
The study involved 22 (69%) males and 10 (31%) females aged from 31 to 65 years. On admission, there were 16 (50%) febrile individuals, 27 (84.4%) with positive meningeal signs, 17 (53.2%) with pathological neurological signs, and 10 (31.3%) with consciousness disorders. WNV infection was confirmed by the method enzyme linked immuno sorbent assay (ELISA) in all the patients, while Reverse Transcription Polymerase Chain Reaction (RT-PCR) test was positive in 3 (30%) of the tested patients. Cardiovascular comorbidities dominated in 7 (21.9%) of the cases. Full recovery was accomplished in 87.5% of the cases.
The results of our study show that the absence of meningeal signs and fever on the day 7 of hospital treatment are indicators of good course and prognosis of neuroinvasive forms of WNV infection. Comorbidities do not increase the risk of disease. ELISA test is a sovereign diagnostic method. In most cases, after the administered symptomatic therapy, the complete recovery of patients was achieved.
背景/目的：西尼罗河病毒（WNV）是一种嗜神经性RNA病毒颗粒，属于黄病毒科黄病毒属。它在蚊子和鸟类之间的传播循环中通过节肢动物得以维持。在人群中，WNV感染大多（80%的病例）没有症状。不到1%的患者会发展为该疾病的神经侵袭性形式——脑膜炎、脑炎或急性弛缓性麻痹。本研究的目的是确定WNV感染患者最常见的临床和实验室表现，强调合并症的存在情况以及治疗结果。
这项回顾性研究于2012年1月1日至2013年12月31日期间进行，评估了32例根据临床症状、实验室检查和血清学检测确诊为WNV感染的患者。为评估统计学意义，我们使用了χ2检验和t检验。
该研究纳入了22名（69%）男性和10名（31%）女性，年龄在31至65岁之间。入院时，有16名（50%）发热患者，27名（84.4%）有脑膜刺激征阳性，17名（53.2%）有病理神经体征，10名（31.3%）有意识障碍。所有患者均通过酶联免疫吸附测定（ELISA）方法确诊为WNV感染，而逆转录聚合酶链反应（RT-PCR）检测在3名（30%）受检患者中呈阳性。7例（21.9%）病例中以心血管合并症为主。87.5%的病例实现了完全康复。
我们的研究结果表明，住院治疗第7天时无脑膜刺激征和发热是WNV感染神经侵袭性形式病程良好及预后良好的指标。合并症不会增加疾病风险。ELISA检测是一种可靠的诊断方法。在大多数情况下，给予对症治疗后，患者实现了完全康复。
