Three case reports of West Nile virus neuroinvasive disease: lessons from real-life clinical practice

Abstract Background Despite being an uncommon cause of meningoencephalitis, West Nile virus (WNV) recently provoked significant outbreaks throughout Europe. West Nile neuroinvasive disease (WNND) is associated with significant morbidity and mortality in older and compromised individuals, while its d...

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Autores principales:	Camilla Falcinella, Marina Allegrini, Lidia Gazzola, Giovanni Mulè, Daniele Tomasoni, Ottavia Viganò, Antonella d’Arminio Monforte, Giulia Marchetti, Camilla Tincati
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	West Nile virus Arbovirus Neuroinvasive disease Cerebrospinal fluid Case report Infectious and parasitic diseases RC109-216
Acceso en línea:	https://doaj.org/article/c253ec12dcd34a3b9e5bd2b3bf0f257e
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spelling	oai:doaj.org-article:c253ec12dcd34a3b9e5bd2b3bf0f257e2021-11-08T11:18:46ZThree case reports of West Nile virus neuroinvasive disease: lessons from real-life clinical practice10.1186/s12879-021-06827-91471-2334https://doaj.org/article/c253ec12dcd34a3b9e5bd2b3bf0f257e2021-11-01T00:00:00Zhttps://doi.org/10.1186/s12879-021-06827-9https://doaj.org/toc/1471-2334Abstract Background Despite being an uncommon cause of meningoencephalitis, West Nile virus (WNV) recently provoked significant outbreaks throughout Europe. West Nile neuroinvasive disease (WNND) is associated with significant morbidity and mortality in older and compromised individuals, while its diagnosis may be demanding for the clinician. Here discussed are three cases of WNND with a focus on the diagnostic challenges they presented due to atypical clinical presentation and laboratory findings. Case presentation Between July and September 2020 three patients presented to our attention with signs and symptoms compatible with meningoencephalitis. Among routine procedures, they underwent lumbar puncture and imaging. In the absence of microbiological isolates, biological samples were sent for serology and NAATs for WNV. Following diagnosis, the patients gradually recovered and were discharged either home or to rehabilitation facilities. Conclusions The laboratory findings here discussed, in particular CSF parameters, are only partially consistent with those described in the literature, which highlights the need for further research. While serology and NAATs on blood and urine appear the most reliable techniques in the diagnostic work-up of WNND, utility of NAATs on CSF specimens is limited by the kinetics of WNV viremia in biological fluids. This report underlines that WNND should always be included in the differential diagnosis of meningoencephalitis during WNV transmission period.Camilla FalcinellaMarina AllegriniLidia GazzolaGiovanni MulèDaniele TomasoniOttavia ViganòAntonella d’Arminio MonforteGiulia MarchettiCamilla TincatiBMCarticleWest Nile virusArbovirusNeuroinvasive diseaseCerebrospinal fluidCase reportInfectious and parasitic diseasesRC109-216ENBMC Infectious Diseases, Vol 21, Iss 1, Pp 1-6 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	West Nile virus Arbovirus Neuroinvasive disease Cerebrospinal fluid Case report Infectious and parasitic diseases RC109-216
spellingShingle	West Nile virus Arbovirus Neuroinvasive disease Cerebrospinal fluid Case report Infectious and parasitic diseases RC109-216 Camilla Falcinella Marina Allegrini Lidia Gazzola Giovanni Mulè Daniele Tomasoni Ottavia Viganò Antonella d’Arminio Monforte Giulia Marchetti Camilla Tincati Three case reports of West Nile virus neuroinvasive disease: lessons from real-life clinical practice
description	Abstract Background Despite being an uncommon cause of meningoencephalitis, West Nile virus (WNV) recently provoked significant outbreaks throughout Europe. West Nile neuroinvasive disease (WNND) is associated with significant morbidity and mortality in older and compromised individuals, while its diagnosis may be demanding for the clinician. Here discussed are three cases of WNND with a focus on the diagnostic challenges they presented due to atypical clinical presentation and laboratory findings. Case presentation Between July and September 2020 three patients presented to our attention with signs and symptoms compatible with meningoencephalitis. Among routine procedures, they underwent lumbar puncture and imaging. In the absence of microbiological isolates, biological samples were sent for serology and NAATs for WNV. Following diagnosis, the patients gradually recovered and were discharged either home or to rehabilitation facilities. Conclusions The laboratory findings here discussed, in particular CSF parameters, are only partially consistent with those described in the literature, which highlights the need for further research. While serology and NAATs on blood and urine appear the most reliable techniques in the diagnostic work-up of WNND, utility of NAATs on CSF specimens is limited by the kinetics of WNV viremia in biological fluids. This report underlines that WNND should always be included in the differential diagnosis of meningoencephalitis during WNV transmission period.
format	article
author	Camilla Falcinella Marina Allegrini Lidia Gazzola Giovanni Mulè Daniele Tomasoni Ottavia Viganò Antonella d’Arminio Monforte Giulia Marchetti Camilla Tincati
author_facet	Camilla Falcinella Marina Allegrini Lidia Gazzola Giovanni Mulè Daniele Tomasoni Ottavia Viganò Antonella d’Arminio Monforte Giulia Marchetti Camilla Tincati
author_sort	Camilla Falcinella
title	Three case reports of West Nile virus neuroinvasive disease: lessons from real-life clinical practice
title_short	Three case reports of West Nile virus neuroinvasive disease: lessons from real-life clinical practice
title_full	Three case reports of West Nile virus neuroinvasive disease: lessons from real-life clinical practice
title_fullStr	Three case reports of West Nile virus neuroinvasive disease: lessons from real-life clinical practice
title_full_unstemmed	Three case reports of West Nile virus neuroinvasive disease: lessons from real-life clinical practice
title_sort	three case reports of west nile virus neuroinvasive disease: lessons from real-life clinical practice
publisher	BMC
publishDate	2021
url	https://doaj.org/article/c253ec12dcd34a3b9e5bd2b3bf0f257e
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Three case reports of West Nile virus neuroinvasive disease: lessons from real-life clinical practice

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