Department of Medicine, AtlantiCare Regional Medical Center, Atlantic City, NJ.
Rowan University School of Osteopathic Medicine, Stanford, NJ.
Perm J. 2021 May;25. doi: 10.7812/TPP/20.288.
Eastern equine encephalitis (EEE) is a rare and potentially fatal neuroinvasive disease with a high mortality rate of > 30%. It is an uncommon vector-borne illness, with an average of 8 cases reported in the United States annually. Alarmingly, in 2019 alone, the Centers for Disease Control and Prevention (CDC) confirmed 38 cases of EEE virus in the United States, reported from 10 states. In this report, we describe a 42-year-old man who worked primarily in wooded areas and presented to a hospital in southern New Jersey with an intractable headache and global facial paraesthesia. He reported multiple tick bites in the weeks prior to his presentation. Based on high clinical suspicion, cerebrospinal samples were sent to the CDC, which confirmed the diagnosis of EEE. The patient was treated with supportive care, and, after spending 9 days on mechanical ventilation in the intensive care unit, he was extubated and subsequently had some improvement of his symptoms with the implementation of an extensive physical therapy program. We hope this report will contribute to increasing awareness among the public health and medical communities regarding the increasing number of EEE cases and the importance of following prevention measures, especially in areas with high prevalence and early recognition of the disease for treatment.
东部马脑炎（EEE）是一种罕见且具有潜在致命性的神经侵袭性疾病，死亡率>30%。它是一种不常见的虫媒传染病，美国每年平均报告 8 例。令人震惊的是，仅在 2019 年，美国疾病控制与预防中心（CDC）就确认了美国 38 例 EEE 病毒病例，这些病例来自 10 个州。在本报告中，我们描述了一位 42 岁的男性，他主要在树林地区工作，因难以控制的头痛和面部全面麻木感就诊于新泽西州南部的一家医院。他报告说在出现症状前的几周内曾多次被蜱虫叮咬。基于高度的临床怀疑，将脑脊液样本送往 CDC，CDC 确诊了 EEE 的诊断。患者接受了支持性治疗，在重症监护病房接受了 9 天的机械通气治疗后，他被拔管，随后通过实施广泛的物理治疗计划，他的症状有所改善。我们希望本报告将有助于提高公共卫生和医疗界对 EEE 病例不断增加的认识，以及对预防措施的重视，特别是在疾病高发和早期发现的地区。
