Uprety Anup, Bhusal Tapasya, Crespo-Quezada Juan, Carmona Pires Felipe, Morgan Christopher
Internal Medicine, Danbury Hospital, Danbury, USA.
Internal Medicine, Connecticut Institute for Communities, Greater Danbury Community Health Center, Danbury, USA.
Cureus. 2025 May 2;17(5):e83373. doi: 10.7759/cureus.83373. eCollection 2025 May.
Powassan virus (POWV) is a single-stranded RNA virus that belongs to the genus , which is transmitted to humans through the bite of infected deer tick (), with peak transmission during summer and fall. Most patients are asymptomatic; those who develop symptoms usually present with flu-like symptoms or neuroinvasive disease, including encephalitis, meningoencephalitis, or aseptic meningitis. The gold standard test for diagnosis is serological testing. The treatment is usually supportive care. In this case series, we have reported two cases that presented with fever, generalized weakness, and changes in mentation, later diagnosed with POWV meningoencephalitis. The magnetic resonance imaging (MRI) findings in the first case were suggestive of herpes simplex virus (HSV), imposing a diagnostic challenge. Patients might end up with cognitive impairment, speech difficulties, headaches, imbalance, and ophthalmoplegia as long-term consequences, and both of our cases had cognitive impairment, and one case had weakness, requiring further neuropsychiatry evaluation, as well as physical therapy. Although cases of POWV encephalitis are very rare, these cases describe the importance of serological testing for POWV, especially in endemic areas, in patients with a known or unknown history of tick bite.
波瓦桑病毒（POWV）是一种单链RNA病毒，属于 属，通过受感染的鹿蜱叮咬传播给人类，在夏季和秋季传播高峰。大多数患者无症状；出现症状的患者通常表现为流感样症状或神经侵袭性疾病，包括脑炎、脑膜脑炎或无菌性脑膜炎。诊断的金标准检测是血清学检测。治疗通常是支持性护理。在这个病例系列中，我们报告了两例出现发热、全身无力和精神状态改变的病例，后来被诊断为波瓦桑病毒脑膜脑炎。第一例病例的磁共振成像（MRI）结果提示为单纯疱疹病毒（HSV），带来了诊断挑战。患者可能会出现认知障碍、言语困难、头痛、平衡失调和眼肌麻痹等长期后果，我们的两例病例都有认知障碍，其中一例有无力症状，需要进一步的神经精神病学评估以及物理治疗。尽管波瓦桑病毒脑炎病例非常罕见，但这些病例说明了对波瓦桑病毒进行血清学检测的重要性，特别是在流行地区，对于有已知或未知蜱叮咬史的患者。
