West nile virus history and symptoms: Difference between revisions

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===Neurovascular Disease===
===Neurovascular Disease===
West Nile encephalitis
Neurovascular involvement is the most severe form of West Nile virus infection. Patients can present with a variety of manifestation in conjunction with fever such as meningitis, flaccid paralysis, encephalitis or a combination of these conditions.


West Nile meningitis
====Constitutional Symptoms====
====Constitutional Symptoms====
* High [[fever]]
* High [[fever]]
Line 45: Line 44:


====Neurological====
====Neurological====
It is the most severe form of the disease. They can present with a variety of manifestation in conjunction with fever like meningitis, flaccid paralysis, encephalitis or a combination of these .
The most common neurological symptoms with their corresponding frequencies are tabulated below.
The most common neurological symptoms with their corresponding frequencies are tabulated below.
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* Deep tendon reflexes are hyperactive at first, later diminished. There are also [[extrapyramidal disorder]]s. Recovery is marked by a long convalescence with fatigue. More recent outbreaks have resulted in a deeper study of the disease and other, rarer, outcomes have been identified.The spinal cord may be infected, marked by [[anterior myelitis]] with or without encephalitis.<ref>Sejvar J J, Haddad M B, Tierney B C, Campbell G L, Marfin A A, VanGerpen J A, Fleischauer A, Leis A A, Stokic D S, Petersen L R. "Neurologic manifestations and outcome of West Nile virus infection." ''JAMA'' 2003; 290: 511-515.</ref> WNV-associated [[Guillain-Barré syndrome]] has been identified<ref>Ahmed S, Libman R, Wesson K, Ahmed F, Einberg K. "Guillain-Barre syndrome: an unusual presentation of West Nile virus infection." ''Neurology'' 2000; 55: 144-146.</ref>
====West nile meningitis====
The main signs and symptoms  are back pain, myalgia, rash , photophobia. Usually it is aseptic meningitis and resolves without major complications.
====West nile meningoencephalitis====
It is the most common form of severe disease presenting as behavioual changes like confusion, irritability, disorientation along with focal signs like tremor, ataxia , bulbar dysfunction, or focal weakness.
====Acute flaccid paralysis====
It usually occurs in the subclinical phase presenting as lower limb weakness  with flaccid tone, areflexia or hyporeflexia.


====Multiorgan abnormality====
====West Nile Meningitis====
* [[Photophobia]]
* [[Headache]]
* [[Back pain]]
* [[Myalgia]]
* [[Rash]]
 
====West Nile Meningoencephalitis====
* [[Confusion]]
* [[Irritability]]
* [[Disorientation]]
* [[Tremor]]
* [[Ataxia]]
* [[Bulbar dysfunction]]
* [[Focal weakness]]
 
====Acute Flaccid Paralysis====
* Lower [[limb weakness]]


* [[Chorioretinitis]] (which has 100% specificity for identifying WNV infection in patients with possible WNV encephalitis)<ref>Abroug F, Ouanes-Besbes L, Letaief M, Ben Romdhane F, Khairallah M, Triki H, Bouzouiaia N. "A cluster study of predictors of severe West Nile virus infection." ''Mayo Clinic Proceedings'' 2006; 81: 12-16.</ref>
====Multiorgan Involvement====
* [[Chorioretinitis]] (100% specificity for identifying West Nile virus infection in patients with possible West Nile virus encephalitis)<ref>Abroug F, Ouanes-Besbes L, Letaief M, Ben Romdhane F, Khairallah M, Triki H, Bouzouiaia N. "A cluster study of predictors of severe West Nile virus infection." ''Mayo Clinic Proceedings'' 2006; 81: 12-16.</ref>
* [[Hepatitis]]
* [[Hepatitis]]
* [[Myocarditis]]
* [[Myocarditis]]

Revision as of 05:00, 11 September 2014

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

The presentation of patients with West Nile fever infection is variable as it can be completely asymptomatic, mild, or very severe. When symptoms are present, the manifestation of West Nile fever infection can range from mild fever, to severe encephalitis, meningitis, coma, and death.

History

Symptoms

West Nile fever infection can present with a variety of manifestation according to the severity of the diseases. West Nile fever infection has three different clinical presentations in humans: asymtomatic, mild febrile syndrome termed West Nile fever, and Neuroinvasive disease termed West Nile meningitis or encephalitis.

Asymptomatic

Absence of symptoms is present in approximately 80% of subjects infected with the West Nile virus.

West Nile Fever

Constitutional Symptoms

Skin Symptoms

Gastrointestinal Symptoms

Neurovascular Disease

Neurovascular involvement is the most severe form of West Nile virus infection. Patients can present with a variety of manifestation in conjunction with fever such as meningitis, flaccid paralysis, encephalitis or a combination of these conditions.

Constitutional Symptoms

Neurological

The most common neurological symptoms with their corresponding frequencies are tabulated below.

Symptom Percentage
Facial Palsy 13%
Dhyphagia 33%
Dysarthria 33%
Diplopia 33%
Tremor 22%
Parkinsonism 16%
Ataxia 31%
Motor seizures 5%
Myoclonus 31%

West Nile Meningitis

West Nile Meningoencephalitis

Acute Flaccid Paralysis

Multiorgan Involvement

References

  1. ↑ Abroug F, Ouanes-Besbes L, Letaief M, Ben Romdhane F, Khairallah M, Triki H, Bouzouiaia N. "A cluster study of predictors of severe West Nile virus infection." Mayo Clinic Proceedings 2006; 81: 12-16.
  2. ↑ Perelman A, Stern J. "Acute pancreatitis in West Nile Fever." American Journal of Tropical Medicine and Hygiene 1974; 23: 1150-1152.
  3. ↑ Omalu B I, Shakir A A, Wang G, Lipkin W I, Wiley C A. "Fatal fulminant pan-meningo-polioencephalitis due to West Nile virus." Brain Pathology 2003; 13: 465-472
  4. ↑ Mathiot C C, Georges A J, Deubel V. "Comparative analysis of West Nile virus strains isolated from human and animal hosts using monoclonal antibodies and cDNA restriction digest profiles." Res Virol 1990; 141: 533-543.


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