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In Vivo Imaging Systems IVIS Detection of a Neuro-Invasive Encephalitic Virus
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West Nile Neuroinvasive Disease: Case Series and Review of the Literature

Rachel Alter1, Stefan Juretschko2, Miriam A Smith1,3

  • 1Department of Medicine, Long Island Jewish Forest Hills (Northwell Health), Forest Hills, NY.

American Journal of Therapeutics
|January 7, 2025
PubMed
Abstract

Insights

West Nile virus (WNV) neuroinvasive disease is underdiagnosed. Consider WNV in patients with neurologic symptoms during summer months, even without cerebrospinal fluid confirmation.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Public Health

Background:

  • West Nile virus (WNV) is the most common mosquito-borne illness in the U.S.
  • It is the second leading cause of viral encephalitis.
  • Neuroinvasive disease affects fewer than 1% of infected individuals.

Purpose of the Study:

  • To present a cluster of neuroinvasive WNV cases.
  • To review literature on WNV neurologic involvement.
  • To highlight diagnostic challenges in WNV infection.

Main Methods:

  • Case series of 3 neuroinvasive WNV patients (August-September 2023).
  • Literature review for neurologic manifestations of WNV.
  • Data sources included EHR, PubMed, and Google.

Main Results:

  • All 3 patients presented with acute encephalopathy and neurologic impairment.
  • Serum serology confirmed WNV in all cases.
  • Only one patient had cerebrospinal fluid confirmation of WNV.

Conclusions:

  • WNV infection, particularly neuroinvasive forms, is often underdiagnosed.
  • Consider WNV in patients with neurologic symptoms during summer in endemic areas.
  • Diagnosis is crucial even without cerebrospinal fluid confirmation.

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