West Nile neuroinvasive disease with poliomyelitis syndrome: A grave phenomenon

West Nile virus infection poses a significant threat, especially during the warmer months when mosquitoes are abundant. Clinicians must remain vigilant for neuroinvasive illness in patients presenting with febrile symptoms and malaise following mosquito exposure. While magnetic resonance imaging and...

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Main Authors: Benjamin Easow, Muhammad Qureshi, Saikiran Mandyam, Stephen Lavanier, Sanjida Jahan, Taylor Delie, Kateryna Feldman, Fnu Anshul
Format: Article
Language:English
Published: SAGE Publishing 2025-06-01
Series:SAGE Open Medical Case Reports
Online Access:https://doi.org/10.1177/2050313X241305165
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author Benjamin Easow
Muhammad Qureshi
Saikiran Mandyam
Stephen Lavanier
Sanjida Jahan
Taylor Delie
Kateryna Feldman
Fnu Anshul
author_facet Benjamin Easow
Muhammad Qureshi
Saikiran Mandyam
Stephen Lavanier
Sanjida Jahan
Taylor Delie
Kateryna Feldman
Fnu Anshul
author_sort Benjamin Easow
collection DOAJ
description West Nile virus infection poses a significant threat, especially during the warmer months when mosquitoes are abundant. Clinicians must remain vigilant for neuroinvasive illness in patients presenting with febrile symptoms and malaise following mosquito exposure. While magnetic resonance imaging and cerebrospinal fluid analysis aid in differential diagnosis, detecting West Nile immunoglobulin M in serum is crucial for definitive diagnosis. Treatment primarily involves supportive care due to the absence of established regimens, though promising outcomes have been reported with plasma exchange and intravenous immunoglobulin. We present the case of an 83-year-old resident of Alabama, an avid gardener living near a pond, who initially exhibited symptoms of productive cough, diarrhea, fever, and generalized malaise. However, within 48 h, he developed hypoxemia, functional quadriplegia, and bulbar palsy necessitating intubation. Diagnostic evaluations, including magnetic resonance imaging and positive West Nile virus immunoglobulin M in serum, confirmed West Nile virus-associated poliomyelitis viral syndrome, prompting intravenous immunoglobulin therapy. This case highlights the importance of promptly identifying and managing West Nile virus infection, especially in regions susceptible to mosquito-borne diseases, and being vigilant of the disease in non-endemic regions. The case also begs the question of the timing and efficacy of intravenous immunoglobulin and plasma exchange in West Nile virus infection and the fact that more data should be collected on these therapies.
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spelling doaj-art-cf4f050d04bb4054a2f8f65cf3b09a5b2025-08-20T02:21:16ZengSAGE PublishingSAGE Open Medical Case Reports2050-313X2025-06-011310.1177/2050313X241305165West Nile neuroinvasive disease with poliomyelitis syndrome: A grave phenomenonBenjamin EasowMuhammad QureshiSaikiran MandyamStephen LavanierSanjida JahanTaylor DelieKateryna FeldmanFnu AnshulWest Nile virus infection poses a significant threat, especially during the warmer months when mosquitoes are abundant. Clinicians must remain vigilant for neuroinvasive illness in patients presenting with febrile symptoms and malaise following mosquito exposure. While magnetic resonance imaging and cerebrospinal fluid analysis aid in differential diagnosis, detecting West Nile immunoglobulin M in serum is crucial for definitive diagnosis. Treatment primarily involves supportive care due to the absence of established regimens, though promising outcomes have been reported with plasma exchange and intravenous immunoglobulin. We present the case of an 83-year-old resident of Alabama, an avid gardener living near a pond, who initially exhibited symptoms of productive cough, diarrhea, fever, and generalized malaise. However, within 48 h, he developed hypoxemia, functional quadriplegia, and bulbar palsy necessitating intubation. Diagnostic evaluations, including magnetic resonance imaging and positive West Nile virus immunoglobulin M in serum, confirmed West Nile virus-associated poliomyelitis viral syndrome, prompting intravenous immunoglobulin therapy. This case highlights the importance of promptly identifying and managing West Nile virus infection, especially in regions susceptible to mosquito-borne diseases, and being vigilant of the disease in non-endemic regions. The case also begs the question of the timing and efficacy of intravenous immunoglobulin and plasma exchange in West Nile virus infection and the fact that more data should be collected on these therapies.https://doi.org/10.1177/2050313X241305165
spellingShingle Benjamin Easow
Muhammad Qureshi
Saikiran Mandyam
Stephen Lavanier
Sanjida Jahan
Taylor Delie
Kateryna Feldman
Fnu Anshul
West Nile neuroinvasive disease with poliomyelitis syndrome: A grave phenomenon
SAGE Open Medical Case Reports
title West Nile neuroinvasive disease with poliomyelitis syndrome: A grave phenomenon
title_full West Nile neuroinvasive disease with poliomyelitis syndrome: A grave phenomenon
title_fullStr West Nile neuroinvasive disease with poliomyelitis syndrome: A grave phenomenon
title_full_unstemmed West Nile neuroinvasive disease with poliomyelitis syndrome: A grave phenomenon
title_short West Nile neuroinvasive disease with poliomyelitis syndrome: A grave phenomenon
title_sort west nile neuroinvasive disease with poliomyelitis syndrome a grave phenomenon
url https://doi.org/10.1177/2050313X241305165
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