1. Acute transverse myelitis in West Nile Virus, a rare neurological presentation
- Author
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Edward R. Wolpow, Daniel L. Bourque, Alejandro Heffess, Stephanie Page, Chinmay Jani, Alexander M. Walker, Omar Al Omari, and Dipesh Patel
- Subjects
0301 basic medicine ,Pediatrics ,medicine.medical_specialty ,Flaccid paralysis ,viruses ,Transverse myelitis ,030106 microbiology ,Lymphocytic pleocytosis ,Case Report ,Infectious and parasitic diseases ,RC109-216 ,03 medical and health sciences ,0302 clinical medicine ,Paralysis ,West Nile Virus ,Medicine ,030212 general & internal medicine ,business.industry ,food and beverages ,virus diseases ,Meningoencephalitis ,medicine.disease ,nervous system diseases ,Infectious Diseases ,Acute Transverse Myelitis ,medicine.symptom ,business ,Meningitis ,Encephalitis - Abstract
Highlights • West Nile Virus can lead to various neurological presentation. • It is important to identify Acute Transverse Myelitis with the help of imaging. • It should be in our differentials in patients presenting with muscular weakness in endemic regions., Introduction West Nile Virus varies in presentation from asymptomatic to a febrile illness often associated with malaise, weakness and maculopapular rash. West Nile neuro-invasive disease often manifests as meningitis, encephalitis, and less commonly acute flaccid paralysis in a "polio-like" presentation. Acute transverse myelitis (ATM) is a rare manifestation. We present a case of neuro-invasive West Nile Virus infection with radiographic evidence of longitudinally extensive transverse myelitis (LETM), a subset of ATM, Case narration A 42-year-old male from Massachusetts presented with progressive asymmetric paralysis of 4 days duration after developing a prodrome of fever, neck stiffness and urinary retention. Physical examination demonstrated asymmetric lower extremity weakness Lumbar puncture revealed lymphocytic pleocytosis with normal protein and glucose and a positive West Nile IgM in CSF (4.89, reference
- Published
- 2021