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Social psychologists have documented that feeling good about ourselves and maintaining positive self-esteem is a powerful motivator of human behavior (Tavris & Aronson, 2008). In the United States, members of the predominant culture typically think very highly of themselves and view themselves as good people who are above average on many desirable traits (Ehrlinger, Gilovich, & Ross, 2005). Often, our behavior, attitudes, and beliefs are affected when we experience a threat to our...
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Confusion beyond the usual suspects.

Lucia Colavolpe1, Piero Tarantini1, Aldo Fici1

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West Nile virus (WNV) encephalitis can cause acute confusion in older adults, mimicking systemic infections. Early diagnosis is crucial, especially during mosquito season in Europe.

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Area of Science:

  • Neurology
  • Infectious Diseases
  • Public Health

Background:

  • Acute confusion in older adults is often misdiagnosed as systemic infection.
  • West Nile virus (WNV) is an emerging cause of viral encephalitis in Europe.

Purpose of the Study:

  • To report a case of WNV neuroinvasive disease in an elderly patient.
  • To emphasize the importance of considering WNV in differential diagnosis of acute confusion in older adults.

Main Methods:

  • Case report of an 82-year-old man with fever, agitation, and confusion.
  • Diagnostic workup included blood tests, CSF analysis, and WNV serology/RT-PCR.
  • Epidemiological history including mosquito bite was crucial.

Main Results:

  • Initial investigations suggested systemic infection; antibacterial therapy was initiated.
  • Lumbar puncture revealed lymphocytic pleocytosis and elevated protein, indicating viral meningoencephalitis.
  • WNV-specific antibodies and RNA confirmed WNV neuroinvasive disease.

Conclusions:

  • WNV encephalitis should be considered in older adults with acute confusion and fever during mosquito season.
  • Epidemiological history, particularly mosquito exposure, is vital for prompt diagnosis.
  • Timely diagnosis and supportive care can lead to recovery.