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Denial

M Tariq Bhatti1, Jennifer R Long1, Andrew R Carey2

  • 1The Permanente Medical Group, Department of Ophthalmology, Kaiser Permanente-Northern California, Roseville, CA, USA.

Survey of Ophthalmology
|May 16, 2024
PubMed

Insights

West Nile virus (WNV) can cause meningoencephalitis with neurological and ocular symptoms. Intravenous fluorescein angiography (IVFA) aids in diagnosing WNV-related chorioretinitis.

Area of Science:

  • Neuroscience
  • Infectious Diseases
  • Ophthalmology

Background:

  • West Nile virus (WNV) is a growing public health concern.
  • WNV infection can lead to severe neurological disease, including meningoencephalitis.

Observation:

  • A 51-year-old male presented with acute neurological symptoms and decreased vision.
  • Brain MRI revealed mesial temporal lobe and optic radiation lesions.
  • Cerebrospinal fluid analysis showed polymorphonuclear pleocytosis and hyperproteinorachia.

Findings:

  • Meningoencephalitis was diagnosed.
  • Intravenous fluorescein angiography (IVFA) identified multifocal, linear chorioretinitis in the left eye.
  • Cerebrospinal fluid (CSF) IgM ELISA confirmed West Nile virus infection.

Implications:

  • This case highlights the diverse clinical spectrum of WNV disease.
  • IVFA is a valuable diagnostic tool for identifying WNV-related ocular manifestations.
  • Early diagnosis and recognition of WNV meningoencephalitis are crucial for patient management.
Keywords:
ChorioretinitisLinearMeningoencephalitisMosquitoWest Nile virus

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