West nile virus myocarditis causing a fatal arrhythmia: a case report

Area of Science:

• Neurology
• Cardiology
• Infectious Diseases

Background:

• West Nile Virus (WNV) is a leading cause of viral encephalitis in the USA.
• WNV infections often present as neuro-invasive disease, but cardiac involvement, specifically myocarditis, has been reported.
• Viral myocarditis can lead to cardiac arrhythmias.

Observation:

• A 65-year-old male presented with symptoms of fever, blurry vision, and decreased oral intake.
• The patient subsequently experienced a fatal cardiac arrhythmia.
• Autopsy and laboratory findings indicated West Nile Virus-induced meningoencephalitis and myocarditis.

Findings:

• This case highlights a rare but fatal complication of West Nile Virus infection: myocarditis leading to fatal arrhythmia.
• The patient's presentation with neurological symptoms preceded the cardiac event, suggesting a systemic inflammatory process.
• Autopsy confirmed encephalitis and myocarditis, directly linking them to West Nile Virus.

Implications:

• Physicians should maintain a high index of suspicion for West Nile Virus-related myocarditis in patients with WNV encephalitis.
• Continuous cardiac monitoring may be warranted for WNV-infected patients, especially those with neurological symptoms, due to the risk of fatal arrhythmias.
• Further research is needed to understand the pathophysiology and incidence of WNV-associated myocarditis and to establish clear clinical guidelines.