tailieunhanh - Báo cáo y học: " The natural history of West Nile virus infection presenting with West Nile virus meningoencephalitis in a man with a prolonged illness: a case report"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: The natural history of West Nile virus infection presenting with West Nile virus meningoencephalitis in a man with a prolonged illness: a case report. | Mainali et al. Journal of Medical Case Reports 2011 5 204 http content 5 1 204 JOURNALOF medical case reports CASE REPORT Open Access The natural history of West Nile virus infection presenting with West Nile virus meningoencephalitis in a man with a prolonged illness a case report Shraddha Mainali1 Mansoor Afshani1 James B Wood3 and Michael C Levin1 2 Abstract Introduction Estimates indicate that West Nile virus infects approximately one and a half million people in the United States of America. Up to 1 may develop West Nile virus neuroinvasive disease in which infected patients develop any combination of meningitis encephalitis or acute paralysis. Case presentation A 56-year-old African-American man presented to our hospital with headache restlessness fever myalgias decreased appetite and progressive confusion. A cerebrospinal fluid examination showed mild leukocytosis and an elevated protein level. Testing for routine infections was negative. Brain T2-weighted magnetic resonance imaging scans showed marked enlargement of caudate nuclei and increased intensity within the basal ganglia and thalami. A West Nile virus titer was positive and serial brain magnetic resonance imaging scans showed resolving abnormalities that paralleled his neurological examination. Conclusion This report is unusual as it portrays the natural history and long-term consequences of West Nile virus meningoencephalitis diagnosed on the basis of serial brain images. Introduction West Nile virus WNV is an arthropod-borne flavivirus transmitted to humans by the bite of an infected mosquito 1 2 . The flavivirus belongs to the Japanese encephalitis virus antigenic complex which was first isolated from a 37-year-old woman living in the West Nile District of Uganda in 1937 1 . Sixty-two years later in the summer of 1999 the virus was first identified in the United States of America where it appeared during an outbreak of naturally acquired meningitis and encephalitis in