West Nile Virus infection with hearing loss

Since the New York outbreak in 1999, West Nile Virus (WNV) has spread across the United States and North America. The spectrum of disease may range from asymptomatic to debilitating neuroinvasive. We present a case of a woman with myasthenia gravis on immunosuppressive therapy who developed WNV meningoencephalitis presenting as flaccid paralysis and severe bilateral hearing loss. To our knowledge this is the first reported case of WNV-associated hearing loss, and the first reported in a patient with previously diagnosed myasthenia gravis. Of epidemiologic interest was that her mother, 81 years old and in previous good health, developed a WNV infection shortly before the patient's infection.