Sciturro Monica, Rehl Sarah, Klingensmith Jessica
Medicine, Nova Southeastern University Dr. Kiran C. Patel College Of Osteopathic Medicine, Clearwater, USA.
Infectious Disease, Nova Southeastern University Dr. Kiran C. Patel College Of Osteopathic Medicine, Davie, USA.
Cureus. 2022 Dec 30;14(12):e33138. doi: 10.7759/cureus.33138. eCollection 2022 Dec.
West Nile virus (WNV) is a leading cause of mosquito-borne illness in the continental United States. There are no vaccines to prevent or treat WNV, the mainstay of treatment is supportive care with rehydration, pain control, and possible antiemetic therapy. WNV is often asymptomatic but can rarely progress to a neuroinvasive disease, depicted by meningitis, encephalitis, and acute flaccid paralysis. This case report depicts a 64-year-old male who developed a rare neuroinvasive WNV in Florida. The patient was hospitalized for bilateral upper and lower extremity weakness, numbness, and tingling. CSF findings on admission were remarkable for albuminocytologic dissociation, suggesting that the patient was possibly suffering from isolated Guillain Barre Syndrome (GBS). The patient was treated with IVIG and plasmapheresis with no improvement in symptoms and later tested positive for WNV on day 22 of admission. This case highlights the variability in WNV presentation and CSF findings, highlighting the need for increased suspicion when patients present with findings consistent with GBS in the late summer months.
西尼罗河病毒（WNV）是美国大陆蚊媒疾病的主要病因。目前尚无预防或治疗WNV的疫苗，治疗的主要手段是支持性护理，包括补液、控制疼痛以及可能的止吐治疗。WNV通常无症状，但很少会发展为神经侵袭性疾病，表现为脑膜炎、脑炎和急性弛缓性麻痹。本病例报告描述了一名64岁男性，他在佛罗里达州患上了罕见的神经侵袭性WNV。患者因双侧上下肢无力、麻木和刺痛入院。入院时脑脊液检查结果显示蛋白细胞分离明显，提示患者可能患有孤立性吉兰-巴雷综合征（GBS）。患者接受了静脉注射免疫球蛋白和血浆置换治疗，但症状无改善，入院第22天晚些时候检测出WNV呈阳性。该病例突出了WNV表现和脑脊液检查结果的变异性，强调在夏末几个月，当患者出现与GBS一致的症状时，需要提高怀疑度。
