ro13-9904 and West-Nile-Fever

Topics: Administration, Intravenous; Adolescent; Anti-Bacterial Agents; Brain; Ceftriaxone; Central Nervous System Viral Diseases; Diagnosis, Differential; Diarrhea; Flushing; Guillain-Barre Syndrome; Headache; Humans; Immunoglobulins, Intravenous; Immunologic Factors; Irritable Mood; Lyme Neuroborreliosis; Magnetic Resonance Imaging; Male; Meningitis, Bacterial; Myelitis; Neck Pain; Paresthesia; Peroneal Neuropathies; Pneumonia, Bacterial; Reflex, Abnormal; Spinal Cord; Sweating; Urinary Retention; West Nile Fever

Topics: Acyclovir; Anti-Infective Agents; Brain; Ceftriaxone; Ciprofloxacin; Consciousness Disorders; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Paresis; Vancomycin; West Nile Fever; West Nile virus

West Nile Virus (WNV) infection is an important cause of encephalitis. Although the medical literature contains examples of WNV encephalitis in susceptible, mainly elderly, immunocompromised hosts, few case reports have described pediatric cases. The authors describe an adolescent with acute lymphocytic leukemia and WNV encephalitis. Surveillance studies indicate an increase in WNV activity. Physicians need to be aware of WNV activity in their community and consider WNV as a potential source of infection.

Topics: Acyclovir; Adolescent; Animals; Antibodies, Viral; Antineoplastic Combined Chemotherapy Protocols; Antiviral Agents; Brain; Ceftazidime; Ceftriaxone; Culicidae; Diagnosis, Differential; Encephalitis, Viral; Fatal Outcome; Humans; Immunoglobulins, Intravenous; Insect Bites and Stings; Magnetic Resonance Imaging; Male; Mercaptopurine; North Carolina; Persistent Vegetative State; Precursor Cell Lymphoblastic Leukemia-Lymphoma; Prednisone; Vancomycin; Vincristine; Virginia; West Nile Fever; West Nile virus

Topics: Acyclovir; Ceftriaxone; Child, Preschool; Communicable Diseases, Emerging; Drug Therapy, Combination; Follow-Up Studies; Glasgow Coma Scale; Humans; Infusions, Intravenous; Male; Ontario; Risk Assessment; Severity of Illness Index; Treatment Outcome; West Nile Fever; West Nile virus

West Nile Fever (WNF) is caused by a B arbovirus, which was first isolated in 1937 in Uganda. In Israel the disease bears an epidemic character, and during 1950-1957 several widespread outbreaks of WNF were described in detail. It emerged from obscurity in 1999 when the first incursion of the virus in North America caused 62 cases of encephalitis and 7 deaths in New York. In 1996 an outbreak in Romania signaled that WNF had emerged as clinically important disease in Europe. The virus is transmitted by a mosquito vector. Wild birds serve as amplifying hosts. Human and some domestic animals such as horses, can be infected incidentally. While neurological disease has been prominent in some epidemics, the West Nile virus infection is usually asymptomatic in areas of the world where the virus is endemic. This is a case study of the first patient diagnosed and treated for West Nile Fever in the Western Galilee, Israel. The epidemiology, pathogenesis, clinical manifestations, diagnosis and treatment of the disease are presented in detail.

Topics: Aged; Antibodies, Viral; Ceftriaxone; Disease Outbreaks; Humans; Immunoglobulin M; Israel; Male; West Nile Fever