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Eastern equine encephalomyelitis with hematuria and bladder dysfunction

S R Lavoie1, S Markowitz, S J Kapadia

  • 1Department of Internal Medicine, Virginia Commonwealth University, Medical College of Virginia, Richmond 23298.

Southern Medical Journal
|July 1, 1993
PubMed
Summary
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Eastern Equine Encephalitis (EEE) was diagnosed in a patient from non-endemic central Virginia. Unusual symptoms included bladder dysfunction and mood changes, highlighting the need for high suspicion in EEE diagnosis.

Area of Science:

  • Arthropod-borne viral diseases
  • Neurovirology
  • Infectious diseases

Background:

  • Eastern Equine Encephalitis (EEE) is a rare but severe arboviral disease primarily affecting the central nervous system.
  • EEE is typically endemic to specific geographic regions, and cases outside these areas are uncommon.
  • Prompt diagnosis and management are crucial due to the high mortality and potential for long-term neurological sequelae.

Observation:

  • A patient presented with encephalomyelitis and unusual symptoms including bladder dysfunction, hematuria, and significant mood and affect disturbances.
  • These presenting features mimicked St. Louis encephalitis, complicating the initial differential diagnosis.
  • The patient acquired the infection in central Virginia, an area not typically considered endemic for EEE.

Findings:

Related Experiment Videos

  • Diagnosis of arboviral encephalomyelitis was considered due to severe central nervous system (CNS) and spinal cord involvement.
  • Specific IgM antibodies detected in both cerebrospinal fluid (CSF) and serum confirmed the diagnosis of EEE.
  • The case highlights the importance of considering EEE even in non-endemic regions.

Implications:

  • A high index of suspicion is necessary for diagnosing EEE, particularly in atypical geographic locations.
  • Recognizing unusual presentations of EEE is vital for timely and accurate diagnosis.
  • This case expands the known geographic range for EEE and emphasizes the need for broader diagnostic considerations.