Rapidly fatal West Nile virus meningoencephalitis in an immunocompetent patient: a case report
encephalitis; meningoencephalitis; neuroinvasive disease; West Nile virus; fatal meningoencephalitis.
Figure 1. Patient’s temperature chart. Auricular temperature was taken four times a day (6 a.m., 12 a.m., 18 p.m., 12 p.m.)
On the third day of admission the patient began lethargic with a Glasgow come score < 8.A head CT scan showed a slightly enlarged ventricular system without evidence of ischemic or hemorrhagic stroke, space-occupying lesions or asymmetry (Figure 2).
As underlined above, risk factors for poor prognosis are still not clearly identified to date.
A variety of factors might contribute to fatal outcome (e.g. immunosuppression states, diabetes, age) but more comprehensive epidemiologic and clinical summaries are needed. Our patient had an advanced age and suffered from diabetes mellitus and arterial hypertension. He underwent unexpected rapid clinical deterioration before any invasive treatment could be carried out. Thus, data on larger numbers of fatal WNV cases may help to promptly recognize high-risk patients who could benefit from early invasive management.
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