Clinic of Anesthesia and Intensive Care, Adana City Training and Research Hospital, Adana, Turkey
Department of Anesthesia and Intensive Care, Çukurova University School of Medicine, Adana, Turkey
Balkan Med J. 2019 Aug 22;36(5):287-289. doi: 10.4274/balkanmedj.galenos.2019.2018.12.74. Epub 2019 Jun 20.
West Nile virus is an arthropod-borne virus (arbovirus) and emerging cause of significant illness in European and Mediterranean countries. West Nile virus infection can cause severe and potentially fatal neurological illnesses, including encephalitis, meningitis, and acute flaccid paralysis. Additionally, immunosuppression, alcohol abuse, old age, and diabetes mellitus are common factors associated with West Nile neuroinvasive disease.
In August 2018, a 60-year-old male patient with a history of diffuse large B-cell lymphoma initially presented with symptoms including abdominal pain and distention, nausea, and vomiting. Three days after open abdominal surgery due to adhesive small bowel obstruction, he developed fever, prominent tremors, and rapidly progressing flaccid paralysis. The identification of West Nile virus RNA in the serum sample led to the diagnosis of West Nile neuroinvasive disease.
Clinicians should evaluate patients with acute flaccid paralysis for the evidence of West Nile neuroinvasive disease. It is particularly important for healthcare providers to consider West Nile neuroinvasive disease in the differential diagnosis of aseptic meningitis, encephalitis, and acute paralysis cases, especially in endemic areas.
西尼罗河病毒是一种虫媒病毒（arbovirus），也是欧洲和地中海国家发生严重疾病的新兴原因。西尼罗河病毒感染可导致严重且可能致命的神经系统疾病，包括脑炎、脑膜炎和急性弛缓性麻痹。此外，免疫抑制、酗酒、年老和糖尿病是与西尼罗河神经侵袭性疾病相关的常见因素。
2018 年 8 月，一位 60 岁男性患者，既往患有弥漫性大 B 细胞淋巴瘤，最初出现腹痛和腹胀、恶心和呕吐等症状。在因粘连性小肠梗阻行剖腹手术后 3 天，他出现发热、明显震颤和迅速进展的弛缓性瘫痪。血清样本中检测到西尼罗河病毒 RNA，从而确诊西尼罗河神经侵袭性疾病。
临床医生应评估急性弛缓性麻痹患者是否有西尼罗河神经侵袭性疾病的证据。对于无菌性脑膜炎、脑炎和急性瘫痪病例，特别是在流行地区，医疗保健提供者特别需要考虑西尼罗河神经侵袭性疾病的鉴别诊断。
