The classic presentation of meningitis is a triad of fever, altered mental status, and nuchal rigidity. Meningitis present with headache Headache The symptom of pain in the cranial region. [lecturio.com]

Infections may be limited to an influenza-like illness or present as an aseptic meningitis or encephalitis. Clinical manifestations of the encephalitic presentation may include seizures, lethargy, myoclonus, focal neurologic signs, coma, and death. [ebi.ac.uk]

All cases had a clinical presentation of encephalitis and were confirmed serologically. Clinically most cases presented with fever, meningitis syndrome with altered mental status. Tremors were common (56% of cases). There were three deaths. [ncbi.nlm.nih.gov]

• Fever

  Clinician–Patient Relationship develop rapid onset of fever Fever Fever is defined as a measured body temperature of at least 38°C (100.4°F). [lecturio.com]

  /immunology West Nile Fever/transmission West Nile Fever/veterinary* West Nile Fever/virology West Nile virus/genetics* West Nile virus/immunology West Nile virus/physiology Substance Viral Nonstructural Proteins Grant support AI065359 /NH/NIH HHS/United [ncbi.nlm.nih.gov]

  These symptoms include fever, headache, stiff neck, confusion, and altered level of consciousness. Coma, convulsions, paralysis, and sometimes death may occur. [msmosquito.org]

  Louis encephalitis Tick-borne encephalitis West Nile encephalitis Yellow fever Zika fever References[edit] ^ a b Simmonds, P; Becher, P; Bukh, J; Gould, E; Meyers, G; Monath, T; Muerhoff, S; Pletnev, A; Rico-Hesse, R; Smith, D; Stapleton, J; ICTV Report [en.wikipedia.org]

• High Fever

  Louis encephalitis infections produce mild symptoms that include fever and headache. In more severe cases, high fever, neck stiffness, disorientation, tremors, coma, and convulsions can occur. [valentbiosciences.com]

  Louis Encephalitis will have no symptoms or signs and never feel sick Mild Symptoms: Most of those who do have symptoms or signs will have a fever and headaches Severe Symptoms: Few of those infected have the severe symptoms such as high fever, severe [smcmvcd.org]

  Severe Symptoms: Headache High fever Neck stiffness Stupor Disorientation Coma Tremors Additional Resources: California Department of Public Health: St Louis Encephalitis Centers for Disease Control and Prevention: St Louis Encephalitis [shastamosquito.org]

  The mild form of the disease results in fever and headaches. Serious cases of the illness include symptoms such as high fever, neck stiffness and persisting headaches. [mosquitonix.com]

• Chills

  Symptomatology on admission included fever, chills, severe headache, abdominal pain, myalgia, arthralgia and jaundice. SLE virus was isolated from her blood drawn on the 8th day of illness and subsequent seroconversion was documented. [ncbi.nlm.nih.gov]

  Fever is commonly associated with chills, rigors, sweating, and flushing of the skin. [lecturio.com]

  Disease onset is characterized by generalized malaise, fever, chills, headache, drowsiness, nausea, and sore throat or cough followed in 1 to 4 days by meningeal and neurologic signs. [mayocliniclabs.com]

  Clinical Features The incubation period varies from 3 to 6 days, following which there is an abrupt onset of chills, fever, and headache. [virology-online.com]

• Rigor

  Common symptoms were fever, rigors, diarrhea, headache, and confusion. One patient died 3 days after hospitalization. [ncbi.nlm.nih.gov]

  Fever is commonly associated with chills, rigors, sweating, and flushing of the skin. [lecturio.com]

  %/protein/Gluc Treatment 69/m Kidney 7/28/2015 9/2/2015 Survived 27/14%/50/86 INF+IVIG 67/m Kidney 12/13/2013 7/24/2015 Died 102/36%/108/54 None 57/m Kidney/heart 10/6/2012 7/2/2105 Survived 84/16%/114/58 INF+IVIG Most common symptoms: fever (3/3), rigors [atcmeetingabstracts.com]

  Epidemiology United States statistics Determining the true incidence of encephalitis is impossible, because reporting policies are neither standardized nor rigorously enforced. [emedicine.medscape.com]

• Nausea

  Depending on the symptoms, options may be: Pain medicines—for headaches Anti-nausea medicines Fluids—by mouth or IV Breathing support Prevention To reduce the risk of St. [winchesterhospital.org]

  Initial symptoms of those who become ill include fever, headache, nausea, vomiting, and tiredness. Severe neuroinvasive disease (often involving encephalitis, an inflammation of the brain) occurs more commonly in older adults. [tn.gov]

  Those people who do become ill may experience fever, headache, nausea, vomiting, and tiredness. [cdc.gov]

  Louis encephalitis-infected mosquito do not become ill, but those who do will experience symptoms such as fever, headache, nausea, vomiting and fatigue. [latimes.com]

  […] by a virus of the Flaviviridae family transmitted by an infected mosquito, and characterized by the onset of flulike symptoms such as fever, malaise, headache, cough, and sore throat that can progress to meningitis or encephalitis with symptoms like nausea [orpha.net]

• Vomiting

  Initial symptoms of those who become ill include fever, headache, nausea, vomiting, and tiredness. Severe neuroinvasive disease (often involving encephalitis, an inflammation of the brain) occurs more commonly in older adults. [tn.gov]

  Those people who do become ill may experience fever, headache, nausea, vomiting, and tiredness. [cdc.gov]

  Louis encephalitis-infected mosquito do not become ill, but those who do will experience symptoms such as fever, headache, nausea, vomiting and fatigue. [latimes.com]

  […] virus of the Flaviviridae family transmitted by an infected mosquito, and characterized by the onset of flulike symptoms such as fever, malaise, headache, cough, and sore throat that can progress to meningitis or encephalitis with symptoms like nausea, vomiting [orpha.net]

  Those who do develop symptoms may experience fever, headache, nausea, vomiting, and tiredness. [ksnblocal4.com]

• Hypertension

  Hypertension and vascular disease may predispose to neuroinvasive disease, but this epidemiologic study has not ruled out the confounding effects of age. [ncbi.nlm.nih.gov]

  During the evolution he added: mental confusion, photophobia, inability to recognize parents or medical staff, obey simple commands, and arterial hypertension. 6 days after he spontaneously improved. IgM for St. [scienceopen.com]

  License: Public Domain Host risk factors Risk factors for developing SLEV infection: Older age (most important) Outdoor activities in endemic areas Comorbidities: Cardiovascular disease Hypertension Hypertension Hypertension, or high blood pressure, is [lecturio.com]

• Photophobia

  Photophobia, cranial nerve palsies, and even coma may occur. [orpha.net]

  During the evolution he added: mental confusion, photophobia, inability to recognize parents or medical staff, obey simple commands, and arterial hypertension. 6 days after he spontaneously improved. IgM for St. [scienceopen.com]

  Photophobia is seldom present. The neurologic examination findings are usually normal. Five percent of patients with SLEV infection present with deep coma, and 25% develop cranial nerve palsies. Fewer exhibit ataxia. [emedicine.medscape.com]

  Fever Neck stiffness Neck Stiffness Meningitis Photophobia Photophobia Abnormal sensitivity to light. This may occur as a manifestation of eye diseases; migraine; subarachnoid hemorrhage; meningitis; and other disorders. [lecturio.com]

• Diplopia

  Additional signs noted at, or after, admission to the hospital were nystagmus, diplopia, ophthalmoplegia, respiratory insufficiency, tremor, ataxia, peripheral weakness, confusion, or decreased level of consciousness. [doi.org]

• Dysuria

  Illness is classified into 3 syndromes: Constitutional symptoms, fever, headache, myalgia, cough, sore throat, dysuria, urinary urgency Aseptic meningitis Fatal encephalitis Symptoms: Asymptomatic in the vast majority (>99%) Malaise, fever, headache, [visualdx.com]

  Pharyngitis Urinary: Dysuria Dysuria Painful urination. It is often associated with infections of the lower urinary tract. [lecturio.com]

  […] encephalitis include the following: Encephalitis caused by varicella-zoster virus (VZV), Epstein-Barr virus (EBV), cytomegalovirus (CMV), measles virus, or mumps virus: Rash, lymphadenopathy, hepatosplenomegaly, and parotid enlargement St Louis encephalitis: Dysuria [emedicine.medscape.com]

• Headache

  Fever Headache Headache The symptom of pain in the cranial region. It may be an isolated benign occurrence or manifestation of a wide variety of headache disorders. [lecturio.com]

  These symptoms include fever, headache, stiff neck, confusion, and altered level of consciousness. Coma, convulsions, paralysis, and sometimes death may occur. [msmosquito.org]

  Depending on the symptoms, options may be: Pain medicines—for headaches Anti-nausea medicines Fluids—by mouth or IV Breathing support Prevention To reduce the risk of St. [winchesterhospital.org]

  Initial symptoms of those who become ill include fever, headache, nausea, vomiting, and tiredness. Severe neuroinvasive disease (often involving encephalitis, an inflammation of the brain) occurs more commonly in older adults. [tn.gov]

  Louis encephalitis is characterized by generalized malaise, fever, chilliness, headache, drowsiness, nausea, and sore throat or cough followed in 1 to 4 days by the meningeal and neurologic signs. [microbiology.testcatalog.org]

• Confusion

  Flaviviridae family transmitted by an infected mosquito, and characterized by the onset of flulike symptoms such as fever, malaise, headache, cough, and sore throat that can progress to meningitis or encephalitis with symptoms like nausea, vomiting, confusion [orpha.net]

  tremors, clumsiness, and ataxia Confusion, delirium or somnolence with weakness, seizures Occasionally, tremulousness with cerebellar and cranial nerve deficits Neurologic and psychologic sequelae are not uncommon Hematuria Incubation period is 4-21 [visualdx.com]

  These symptoms include fever, headache, stiff neck, confusion, and altered level of consciousness. Coma, convulsions, paralysis, and sometimes death may occur. [msmosquito.org]

  Symptoms may be: Fever Headache or stiff neck Feeling dizzy or lightheaded Nausea Weakness Uncontrolled body movements Loss of control of muscles Confusion, lack of responsiveness, or coma Diagnosis The doctor will ask about your symptoms and health history [winchesterhospital.org]

  Common symptoms were fever, rigors, diarrhea, headache, and confusion. One patient died 3 days after hospitalization. [ncbi.nlm.nih.gov]

• Dizziness

  Onset of illness is usually abrupt, with fever, headache, dizziness, nausea, and malaise. Signs and symptoms intensify over a period of several days to a week. [vdh.virginia.gov]

  Symptoms usually start abruptly, with fever, headache, dizziness, nausea, and generalized weakness. They typically get worse over a period of several days to a week. Some patients recover after this period. [cdc.gov]

  Symptoms of onset illness include fever, headache, dizziness, nausea and malaise. Most commonly, severe cases of SLEV occur in elderly people. Cases of children with SLEV are generally milder than cases in elderly. [alabamapublichealth.gov]

  Symptoms may be: Fever Headache or stiff neck Feeling dizzy or lightheaded Nausea Weakness Uncontrolled body movements Loss of control of muscles Confusion, lack of responsiveness, or coma Diagnosis The doctor will ask about your symptoms and health history [winchesterhospital.org]

  The onset of symptoms is usually abrupt, with fever, headache, dizziness, nausea, and malaise. Signs and symptoms intensify over a period of several days to a week. [in.gov]

• Irritability

  […] infected mosquito, and characterized by the onset of flulike symptoms such as fever, malaise, headache, cough, and sore throat that can progress to meningitis or encephalitis with symptoms like nausea, vomiting, confusion, stiff neck, disorientation, irritability [orpha.net]

  Symptoms of irritability, sleeplessness, depression, memory loss, and headaches can last up to 3 years. Areas of outbreaks since 1933 have involved the western United States, Texas, the Ohio-Mississippi Valley, and Florida. [microbiology.testcatalog.org]

  Other symptoms include fever, nausea, stiff neck/back, light sensitivity, confusion, drowsiness, irritability, and motor skill impairment. Wild bird populations are central to the transmission cycle. [amcdsjc.org]

  Symptoms of irritability, sleeplessness, depression, memory loss, and headaches can last up to 3 years. Infections with arboviruses, including SLE, can occur at any age. [mayocliniclabs.com]

• Neck Stiffness

  Symptoms usually appear 5-15 days after the bite of an infected mosquito and may include: Headache Fever Neck stiffness Rash Joint pain Stupor Disorientation Tremors Convulsions—especially in infants Paralysis Coma Diagnosis Your doctor will ask about [wnyurology.com]

  In more severe cases, high fever, neck stiffness, disorientation, tremors, coma, and convulsions can occur. Fatality rates range from 5%–30%, with the elderly more likely to suffer fatal infections.* [valentbiosciences.com]

  Severe Symptoms: Headache High fever Neck stiffness Stupor Disorientation Coma Tremors Additional Resources: California Department of Public Health: St Louis Encephalitis Centers for Disease Control and Prevention: St Louis Encephalitis [shastamosquito.org]

  Clonus and neck stiffness were detected at physical exam. Cerebrospinal fluid revealed mononuclear leukocytosis; bilateral ischemic compromise was observed in thalamus by magnetic resonance. [ncbi.nlm.nih.gov]

  More severe disease is marked by fever, headache, neck stiffness, stupor, disorientation, coma, tremors, occasional convulsions (especially in infants) and spastic (but rarely flaccid) paralysis. [cdc.gov]

Technical Appendix: Additional description of diagnostic workup and methods used in study of fatal human case of St. Louis encephalitis virus infection. [ncbi.nlm.nih.gov]

• Periodic Lateralized Epileptiform Discharges

  Electroencephalograms were obtained for 9 patients and results on all were abnormal, showing status epilepticus (1 patient) ( Figure 1 ), bilateral periodic lateralized epileptiform discharges (1 patient), and background diffuse slowing (7 patients). [jamanetwork.com]

• Hyponatremia

  […] from SIADH,[12] and therefore, its related complications including cerebral edema and central pontine myelinolysis (from overly rapid correction of hyponatremia.). [ncbi.nlm.nih.gov]

• Hypocapnia

  In two of the conscious patients cerebral blood flow was normal despite normal arterial oxygen tension and systemic hypocapnia; inflammatory cerebral vasodilatation may have accounted for the findings. [annals.org]

There is currently no therapeutic treatment for SLE. Current methods consist primarily of symptom treatment and supportive care. Many SLE epidemics have been documented in North America. In 1990, there were 223 cases in Florida. [floridahealth.gov]

Treatment There is no specific treatment for St. Louis encephalitis. Treatment will focus on managing your symptoms and complications, such as through supporting breathing and providing fluids. Prevention There is no vaccine against St. [wnyurology.com]

On this page: Transmission | Signs and Symptoms | Diagnosis | Treatment | Prevention | Maps and Statistics | Information for Providers St. Louis encephalitis virus. Centers for Disease Control and Prevention. [in.gov]

Treatment There is no specific treatment for St. Louis encephalitis. Treatment depends on how severe the disease is. The goal is to manage symptoms and problems. [winchesterhospital.org]

In severe cases, patients often need to be hospitalized to receive supportive treatment, such as intravenous fluids, pain medication, and nursing care. To learn more about treatment, visit our Healthcare Providers page. [cdc.gov]

The EEG proved valuable in diagnosis and prognosis. Results of brain scans were normal. Virus in CSF or urine was not demonstrated, nor was viral antigen in CSF or urine sediments. [archinte.jamanetwork.com]

Sections Continuing Education Activity Introduction Etiology Epidemiology Pathophysiology History and Physical Evaluation Treatment / Management Differential Diagnosis Prognosis Complications Deterrence and Patient Education Enhancing Healthcare Team [pubmed.ncbi.nlm.nih.gov]

Prognosis The mortality rate of St. Louis encephalitis is 2-30%. This figure is higher in older patients. [7] Of persons who survive St. [emedicine.com]

Prognosis The mortality rate of St. Louis encephalitis is 2-30%. This figure is higher in older patients. [9] Of persons who survive St. [emedicine.medscape.com]

Louis encephalitis virus (SLEV) as the etiologic agent. [ncbi.nlm.nih.gov]

Etiology and Pathophysiology St. Louis encephalitis is caused by an enveloped, single-stranded, positive-sense ribonucleic acid (RNA) virus of the Flaviviridae subgroup. St. [emedicine.com]

Louis Encephalitis Tree Number: B04.820.230.475.330 B04.820.250.350.300.330 Definition English: A species of FLAVIVIRUS, one of the Japanese encephalitis virus group (ENCEPHALITIS VIRUSES, JAPANESE), which is the etiologic agent of ST. [decs.bvs.br]

• The majority of infections are subclinical or result in mild illness Etiologic Agent: • St. Louis encephalitis virus - flavivirus related to Japanese encephalitis virus Sequelae: • Hospitalization for CNS infection - 95% of recognized cases. [mosquitocontrol.org]

Louis/epidemiology* Encephalitis, St. Louis/history Encephalitis, St. Louis/transmission Encephalitis, St. [ncbi.nlm.nih.gov]

[…] their influence in epidemiology, virulence and biological characteristics. [elsevier.es]

Etiology and Pathophysiology St. Louis encephalitis is caused by an enveloped, single-stranded, positive-sense ribonucleic acid (RNA) virus of the Flaviviridae subgroup. St. [emedicine.medscape.com]

Pathophysiology Viremia from Saint Louis encephalitis virus infection occurs after replication in the region of the mosquito bite and local lymph nodes. In most cases, the virus will clear within 7 days. [ncbi.nlm.nih.gov]

Prevention The best way to prevent SLEV disease is to avoid mosquito bites. Please see our mosquito prevention page for more information. For more information about St. Louis encephalitis virus, visit the CDC SLEV webpage. [in.gov]

Centers for Disease Control and Prevention SLE webpage (http://www.cdc.gov/sle/index.html). [msmosquito.org]

Severe illnesses are treated by supportive therapy which may include hospitalization, respiratory support, intravenous (IV) fluids, and prevention of other infections. How can St. Louis encephalitis be prevented? Prevent mosquito bites. [vdh.virginia.gov]

Available at: https://www.dynamed.com/prevention/mosquito-avoidance. Accessed April 2, 2021. Saint Louis encephalitis fact sheet. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/sle. Accessed April 2, 2021. [winchesterhospital.org]