Roy Archa, Ramtahal Vikash A, Tun Yan Naing, Kumar Kantash
Internal Medicine, Maimonides Medical Center, New York City, USA.
Cureus. 2025 Jun 11;17(6):e85760. doi: 10.7759/cureus.85760. eCollection 2025 Jun.
West Nile virus (WNV) is a mosquito-borne ribonucleic acid (RNA) virus usually transmitted by mosquitoes. While most infections are asymptomatic, WNV can cause severe neuroinvasive disease, including meningitis and encephalitis, with rare cases of seizures and strokes. Diagnosis typically involves detecting WNV-specific immunoglobulin M (IgM) antibodies or viral RNA. Management is supportive. This report details an unusual WNV presentation in a 50-year-old male patient with chronic lymphocytic leukemia (CLL) who experienced gastrointestinal symptoms and persistent high-grade fevers in early fall. This atypical presentation initially led to a diagnosis of pyrexia of unknown origin (PUO), delaying proper identification. The case highlights the importance of considering arboviral infections like WNV, especially during peak transmission months (July-September), to facilitate prompt diagnosis, reduce unnecessary investigations, and improve healthcare efficiency.
西尼罗河病毒（WNV）是一种通常由蚊子传播的核糖核酸（RNA）病毒。虽然大多数感染是无症状的，但西尼罗河病毒可导致严重的神经侵袭性疾病，包括脑膜炎和脑炎，罕见情况下会出现癫痫发作和中风。诊断通常包括检测西尼罗河病毒特异性免疫球蛋白M（IgM）抗体或病毒RNA。治疗以支持治疗为主。本报告详细介绍了一名50岁慢性淋巴细胞白血病（CLL）男性患者的不寻常西尼罗河病毒表现，该患者在初秋出现胃肠道症状和持续高热。这种非典型表现最初导致诊断为不明原因发热（PUO），延误了正确诊断。该病例强调了考虑像西尼罗河病毒这样的虫媒病毒感染的重要性，特别是在传播高峰期（7月至9月），以便及时诊断，减少不必要的检查，并提高医疗效率。
