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Punctate exanthem of West Nile Virus infection: report of 3 cases

Robert C Anderson1, Keren B Horn, Mai P Hoang

  • 1Department of Dermatology, University of Texas Southwestern Medical School, Dallas, Texas, USA.

Journal of the American Academy of Dermatology
|November 4, 2004
PubMed

Insights

West Nile Virus (WNV) infection can cause a distinct punctate exanthem, primarily on the extremities. This rash, though common, is often overlooked but aids in diagnosing WNV meningoencephalitis.

Area of Science:

  • Infectious Diseases
  • Neurology
  • Dermatology

Background:

  • West Nile Virus (WNV) is a significant cause of meningoencephalitis in North America.
  • Clinical diagnosis of WNV infection is challenging due to nonspecific symptoms.
  • Cutaneous manifestations of WNV are common but not well-documented.

Purpose of the Study:

  • To describe the clinical and histopathologic features of cutaneous eruptions in WNV infection.
  • To highlight the punctate exanthem as a potential diagnostic marker for WNV.

Main Methods:

  • Case series of 3 patients with confirmed WNV infection.
  • Clinical description of skin lesions, including location and morphology.
  • Histopathologic examination of skin biopsy from one patient.
  • Literature review of WNV cutaneous manifestations.

Main Results:

  • Patients presented with punctate erythematous, macular, and papular eruptions, predominantly on extremities.
  • Histopathology revealed a sparse superficial perivascular lymphocytic infiltrate.
  • Literature review supports this exanthem as a frequent presentation of WNV infection.

Conclusions:

  • A punctate exanthem is a common, albeit often uncharacterized, cutaneous manifestation of West Nile Virus infection.
  • Recognizing this rash can aid in the clinical diagnosis of WNV meningoencephalitis.
  • Further research into WNV-associated dermatologic findings is warranted.

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