Peters Steven, Brown Kristen
Department of Clinical Neurosciences, Calgary Stroke Program, University of Calgary, Alberta, Canada.
Department of Medicine and Pathology and Laboratory Medicine, University of Calgary, Alberta, Canada.
Neurohospitalist. 2021 Jan;11(1):62-65. doi: 10.1177/1941874420940944. Epub 2020 Jul 16.
West Nile virus is an emerging infection in North America but has not traditionally been associated with acute vascular events. We report a 57-year-old healthy male who developed pharyngitis and a corporeal rash, followed 1 week later by an acute cryptogenic stroke. Following successful endovascular thrombectomy, cerebrospinal fluid analysis revealed acute West Nile virus infection. While severe cases of vasculopathy have been described with flavivirus infection, stroke associated with relatively mild symptoms has not been. Given increasing evidence that viral and bacterial infections of many varieties may be stroke triggers, West Nile virus and other flaviviruses may represent an uncommon but underappreciated trigger of cryptogenic stroke. We review indirect evidence that viral endothelial tropism or a nonspecific peri-infectious inflammatory state may be causative mechanisms.
西尼罗河病毒在北美是一种新出现的感染源，但传统上它与急性血管事件并无关联。我们报告了一名57岁的健康男性，他先是出现了咽炎和全身性皮疹，1周后又发生了急性隐源性卒中。在成功进行血管内血栓切除术之后，脑脊液分析显示为急性西尼罗河病毒感染。虽然已有关于黄病毒感染导致严重血管病的报道，但与相对较轻症状相关的卒中却未见报道。鉴于越来越多的证据表明多种病毒和细菌感染可能是卒中的触发因素，西尼罗河病毒和其他黄病毒可能是隐源性卒中的一种罕见但未得到充分认识的触发因素。我们回顾了间接证据，表明病毒对内皮细胞的嗜性或非特异性感染周围炎症状态可能是致病机制。
