Department of Medicine, Medical College of Wisconsin and Froedtert Hospital, Milwaukee, Wisconsin,
Department of Medicine, Medical College of Wisconsin and Froedtert Hospital, Milwaukee, Wisconsin.
WMJ. 2022 Jul;121(2):E22-E26.
West Nile virus is an asymptomatic infection in most cases, but it can present with a rare complication of deadly neuroinvasive disease.
A 81-year-old White man presented with altered mental status and fever of unknown origin. After extensive workup, he was diagnosed with West Nile encephalitis based on positive serology, lumbar puncture, and clinical presentation.
West Nile virus is a mosquito-borne RNA arbovirus that, in rare cases, can lead to encephalitis, which is a challenging diagnosis. There is no current treatment; however, a 5-day course of intravenous immunoglobulin seemed to show acute clinical improvement in both mentation and magnetic resonance imaging of the head and no long-term effects.
We report this case to increase awareness among clinicians to include West Nile virus in the differential diagnosis of encephalitis with fever of unknown origin, particularly in endemic areas.
西尼罗河病毒在大多数情况下为无症状感染，但它可引起一种罕见的致命性神经侵袭性疾病的并发症。
一名 81 岁白人男性因精神状态改变和不明原因发热就诊。经过广泛的检查，根据血清学、腰椎穿刺和临床表现，他被诊断为西尼罗河脑炎。
西尼罗河病毒是一种由蚊子传播的 RNA 虫媒病毒，在极少数情况下可导致脑炎，这是一种具有挑战性的诊断。目前尚无治疗方法；然而，5 天疗程的静脉注射免疫球蛋白似乎在精神状态和头部磁共振成像方面显示出急性临床改善，且无长期影响。
我们报告这个病例是为了提高临床医生的认识，将西尼罗河病毒纳入发热原因不明性脑炎的鉴别诊断中，特别是在流行地区。
