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West Nile fever encephalitis
Abstract:
Three cases of meningoencephalitis caused by the West Nile virus in young people are described. All patients had high fever, severe headaches, and meningeal irritation. One patient had papillitis and a maculopapular rash. Lymphadenopathy, which is a common finding in West Nile fever, was not found in any of our patients. Duration of the disease was one to two weeks, and recovery was complete. Cerebrospinal fluid examination revealed an increase in protein and pleocytosis (predominantly polymorphonuclears). We believe that West Nile encephalitis is not rare in Israel.
Insights
West Nile virus can cause meningoencephalitis in young people, presenting with fever and headaches. This study highlights its potential prevalence in Israel, with patients experiencing a full recovery.
Area of Science:
- Neurology
- Infectious Diseases
- Virology
Background:
- West Nile virus (WNV) is a mosquito-borne flavivirus that can cause neurological disease in humans.
- Meningoencephalitis, an inflammation of the brain and meninges, is a severe manifestation of WNV infection.
Observation:
- Three young patients presented with symptoms suggestive of meningoencephalitis, including high fever, severe headaches, and meningeal irritation.
- One patient exhibited additional signs of papillitis and a maculopapular rash.
- Notably, lymphadenopathy, a common indicator of West Nile fever, was absent in all observed cases.
Findings:
- Cerebrospinal fluid analysis revealed elevated protein levels and pleocytosis, predominantly with polymorphonuclear cells, consistent with viral encephalitis.
- The illness duration ranged from one to two weeks, with all patients achieving complete recovery.
- The clinical presentation and cerebrospinal fluid findings in these cases suggest West Nile encephalitis may be more common in Israel than previously thought.
Implications:
- These findings underscore the importance of considering West Nile encephalitis in the differential diagnosis of acute neurological illness in young individuals, particularly in regions where WNV is endemic.
- The absence of lymphadenopathy in these cases broadens the clinical spectrum of West Nile fever, emphasizing the need for vigilant diagnosis.
- Further epidemiological studies are warranted to determine the true prevalence of West Nile encephalitis in Israel and surrounding areas.