We present this case to describe the rarely reported association of purpura fulminans with West Nile Virus infection. [ncbi.nlm.nih.gov]

• Fever

  Patients with encephalitis fared worse than patients with meningitis and fever, considering hospitalization, length of stay, discharge, recovery, and case-fatality. [ncbi.nlm.nih.gov]

  Here are entered works on the virus that causes West Nile fever. Works on the disease caused by the West Nile virus are entered under [West Nile fever.] [id.loc.gov]

  West Nile fever in Oman. Disease Information, 16(48). OIE, 2004. West Nile fever in Belize in october 2003. Disease Information, 17(10). OIE, 2005. West Nile fever in Cuba. Virus detection in equids. Disease Information, 18(7). [cabi.org]

• Fatigue

  Of the 20% that do show symptoms, most experience mild illness with symptoms such as: Fever Headache Body aches Fatigue Skin rash Occasionally, vomiting and nausea Less than 1% of those infected with WNV experience severe illness involving the central [publichealthontario.ca]

  Even non-neurological forms of the disease may cause lasting health effects, including muscle weakness, memory problems and fatigue which may continue for months. [bccdc.ca]

  Most people with this type of West Nile virus disease recover completely, but fatigue and weakness can last for weeks or months. Serious symptoms in a few people. [web.archive.org]

  Most people with these symptoms recover completely, but fatigue and weakness can last for weeks or months. [chesco.org]

  […] severe form of West Nile, West Nile encephalitis West Nile fever West Nile fever symptoms include: sudden onset of high fever (usually >102°F) severe headache nausea vomiting sore throat backache joint pain prominent muscle aches and weakness prolonged fatigue [health.state.mn.us]

• Gangrene

  Biopsy was consistent with purpura fulminans and the patient eventually developed symmetric peripheral gangrene, requiring amputations of all four extremities. [ncbi.nlm.nih.gov]

• Retinal Pigmentation

  Imaging results demonstrate outer retinal and retinal pigment epithelial involvement with inner retinal sparing. [ncbi.nlm.nih.gov]

• Photopsia

  West Nile Virus is a relatively uncommon infection that can involve retinal and choroidal inflammation leading to photopsias, photophobia, and orbital pain. [ncbi.nlm.nih.gov]

• Myalgia

  Common manifestations are fever, headaches, malaise and myalgia. Pancreatitis had been described only twice previously as a complication of WNV infection in the medical literature. [ncbi.nlm.nih.gov]

  Rarely, peripheral demyelination or axonal loss have been postulated. 10 Back to Top Clinical Presentation Systemic Signs and Symptoms Like most viral illnesses, common complaints include fever, fatigue, myalgias, and gastrointestinal symptoms such as [clevelandclinicmeded.com]

• Arthralgia

  Six of these patients had confirmed infection and presented with neuroinvasive illness, whereas the other four suspect cases comprised three cases with arthralgia, myalgia, and/or rash and one case with fever alone. [ncbi.nlm.nih.gov]

• Skin Rash

  The symptoms include a fever, headache, body aches, skin rash, and swollen lymph glands. They can last a few days to several weeks, and usually go away on their own. If West Nile virus enters the brain, however, it can be life-threatening. [medlineplus.gov]

  Most human infections are mild, causing fever, headache, and body aches, often accompanied by a skin rash and swollen lymph glands. [niaid.nih.gov]

  Symptoms of West Nile Virus include fever, body aches, skin rash and swollen lymph nodes. If you suspect you may have WNV, you should seek medical treatment. Copyright 2018 by WJXT News4Jax - All rights reserved. [news4jax.com]

  Of the 20% that do show symptoms, most experience mild illness with symptoms such as: Fever Headache Body aches Fatigue Skin rash Occasionally, vomiting and nausea Less than 1% of those infected with WNV experience severe illness involving the central [publichealthontario.ca]

  About 20 percent of the people who become infected have milder illness such as fever, headache, body aches, nausea, vomiting, and sometimes swollen lymph glands or a skin rash on the chest, stomach and back. [larimer.org]

• Skin Discoloration

  He then developed dusky skin discoloration and systemic flaccid bullae with desquamation. Biopsy was consistent with purpura fulminans and the patient eventually developed symmetric peripheral gangrene, requiring amputations of all four extremities. [ncbi.nlm.nih.gov]

• Purpura

  Purpura fulminans is a progressive thrombotic disorder that presents with widespread purpura due to deficiency or dysfunction of protein C or protein S. [ncbi.nlm.nih.gov]

• Compulsive Disorder

  After the encephalitis lethargica pandemic from 1917 to 1926, depression, mania, and obsessive-compulsive disorder were observed in postencephalitis patients ( 11 ). [dx.doi.org]

• Anger

  When asked to describe their personality change, 19 patients (66%) reported an increase in anger (being short-tempered and irritable); 8 patients (28%) reported being less social; 3 patients (10%) reported increased sensitivity; and 1 patient (3%) reported [dx.doi.org]

• Headache

  A 63-year-old female with no significant past medical history was presented with a 5-day history of progressive opsoclonus-myoclonus, headaches, and fevers. Her workup was significant only for positive West-Nile Virus serum serologies. [ncbi.nlm.nih.gov]

  About 1 in 5 people who are infected develop a fever with other symptoms such as headache, body aches, joint pains, vomiting, diarrhea, or rash. [web.archive.org]

  The symptoms of West Nile non-neurological syndrome include some or all of the following: fever headache muscle weakness muscle and/or joint aches malaise rash sensitivity to light West Nile neurological syndrome In less than one per cent of infected [bccdc.ca]

  The severe symptoms can include high fever, headache, neck stiffness, stupor, disorientation, coma, tremors, convulsions, muscle weakness, vision loss, numbness and paralysis. [larimer.org]

• Brudzinsky Sign

  signs (documentation of Kernig sign, Brudzinski sign, or nuchal rigidity), and CSF suggestive of viral infection; or WNV fever with headache. [dx.doi.org]

  (e.g., seizures) and cerebrospinal fluid (CSF) suggestive of viral infection; WNV meningitis, indicated by fever, meningeal signs (documentation of Kernig sign, Brudzinski sign, or nuchal rigidity), and CSF suggestive of viral infection; or WNV fever [ncbi.nlm.nih.gov]

• Insomnia

  Table 1 Health outcomes assessed during follow-up telephone interviews of New York residents with clinical West Nile virus infection in 1999 a,b Physical health Cognitive health Functional health Difficulty walking c Fatigue Headache Insomnia Joint pain [ncbi.nlm.nih.gov]

  Regardless of acute clinical symptoms, case-patients continued to report difficulty walking, muscle weakness, fatigue, and insomnia, with >40% reporting a combination of these difficulties, and 30% continued to report persistence of memory loss, confusion [dx.doi.org]

• Kernig's Sign

  signs (documentation of Kernig sign, Brudzinski sign, or nuchal rigidity), and CSF suggestive of viral infection; or WNV fever with headache. [dx.doi.org]

  (e.g., seizures) and cerebrospinal fluid (CSF) suggestive of viral infection; WNV meningitis, indicated by fever, meningeal signs (documentation of Kernig sign, Brudzinski sign, or nuchal rigidity), and CSF suggestive of viral infection; or WNV fever [ncbi.nlm.nih.gov]

• Spastic Paralysis

  We describe a 44-year-old man with no past medical history who presented with a meningoencephalitic syndrome and spastic paralysis bilaterally in the upper and lower extremities, hyperreflexia, and myoclonus and was ultimately diagnosed as being infected [ncbi.nlm.nih.gov]

Her workup was significant only for positive West-Nile Virus serum serologies. She received a 2-day course of intravenous immunoglobulin (IvIG). At an 8-week follow up, she had a complete neurological remission. [ncbi.nlm.nih.gov]

• White Matter Lesions

  Brain magnetic resonance imaging demonstrated hyperintense white matter lesions. IgM antibodies against West Nile virus were positive. She was treated for hypertension and with intravenous immunoglobulins and recovered completely within 2 months. [ncbi.nlm.nih.gov]

This case depicts the complexities of the immune responses and their reconstitution following monoclonal antibody treatment and the diversity of neurological syndromes associated with West Nile virus infection. [ncbi.nlm.nih.gov]

Treatment No vaccine or specific antiviral treatments for West Nile virus infection are available. [web.archive.org]

The vector control district said the truck-mounted treatment will begin at 11 p.m. and last about three hours. [mercurynews.com]

Treatment There is no vaccine or specific treatment for WNV infection. You can use over-the-counter pain relievers to reduce fever and relieve some symptoms. In severe cases, patients may need to go to the hospital to get treatment. [durham.ca]

Accurate determination of infection or Chagas' disease activity and prognosis continues to challenge researchers. We hypothesized that a diagnostic platform with higher ligand complexity than previously employed may hold value. [ncbi.nlm.nih.gov]

PubMed Klee AL, Maldin B, Edwin B, Poshni I, Mostashari F, Fine A, Long-term prognosis for clinical West Nile virus infection. Emerg Infect Dis. 2004 ; 10 : 1405 – 11. [dx.doi.org]

Long-term prognosis for clinical West Nile virus. Emerg Infect Dis. 10: 2004; 1405-1411. Back to Top [clevelandclinicmeded.com]

Expectations (prognosis) In general, the likely outcome of a mild West Nile virus infection is excellent. For patients with severe cases of West Nile virus infection, the outlook is more guarded. [sjcphs.org]

Traditional diagnostics failed to identify an etiology. RNA extracted from her cerebrospinal fluid was subjected to unbiased metagenomic deep sequencing, enhanced with the use of a Cas9-based technique for host depletion. [ncbi.nlm.nih.gov]

Depression after encephalitis, regardless of etiology, is not uncommon. [dx.doi.org]

Understanding WNV epidemiology and disease history is important for guiding patient care and healthcare decision-making. [ncbi.nlm.nih.gov]

2019, Week 23 Publication West Nile virus infection - Annual Epidemiological Report for 2016 Publication Communicable disease threats report, 9-15 December 2018, week 50 News Epidemiological update: West Nile virus transmission season in Europe, 2018 [ecdc.europa.eu]

More Event Severe Asthma, Inflammation, and Lung Repair April 26, 2019 This symposium will focus on novel insights into the pathophysiology of severe asthma, airway inflammation, and mechanisms of lung repair and remodeling, and will discuss new therapeutic [nyas.org]

DOI PubMed White MG, Carter NW, Rector FC, Seldin DW, Drewey SJ, Sanford JP, Pathophysiology of epidemic St. Louis encephalitis. Inappropriate secretion of antidiuretic hormone. Ann Intern Med. 1969 ; 71 : 691 – 702. [wwwnc.cdc.gov]

Patients seldom recall a specific mosquito bite, but they are often self-reported active persons with significant outdoor—and therefore mosquito—exposures. 12 Back to Top Pathophysiology WNV is a member of the Japanese encephalitis complex of viruses [clevelandclinicmeded.com]

The first cases were diagnosed and reported to the Hellenic Centre for Disease Control and Prevention (HCDCP) on August 5, 2010 ( 1 ). [doi.org]

You can reduce your risk of WNV by using insect repellent and wearing long-sleeved shirts and long pants to prevent mosquito bites. [cdc.gov]

Preventive measures for WNV, such as surveillance programs, personal protective measures, source reduction, mosquito programs, and vaccine development, are discussed. [ncbi.nlm.nih.gov]

Practice the 4 D's of Prevention! Use Deet or an alternative; Dress in long sleeves and pants; Avoid Dusk until Dawn ; and Drain standing water. [longmontcolorado.gov]