Naslov
West Nile virus presenting as opsoclonus-myoclonus cerebellar syndrome

Autori
Vukelić, Dalibor ; Zember, Sanja ; Oroši, Dorotea

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, znanstveni

Skup
29th ECCMID 2019

Mjesto i datum
Amsterdam, Nizozemska, 13.04.2019. - 16.04.2019

Vrsta sudjelovanja
Poster

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
West Nile virus ; opsoclonus-myoclonus cerebellar syndrome

Sažetak
Background: West Nile virus (WNV) first appeared in the Western hemisphere in 1999 with an outbreak in the New York City area. Most individuals infected with WNV remain asymptomatic. Susceptibility increases with age, chronic illness, and immunosuppression. WNV most commonly causes meningitis and meningoencephalitis, however it can also cause acute flaccid paralysis, as well as focal parenchymal involvement of the cerebellum, brainstem, rhombencephalon, or spinal cord. Case report: We presenta case of a 70-year- old patient admitted to the University Hospital for Infectious Diseases on the 6th day of illness, that started with fever and headache, and from the 3rd day accompanied by vommiting and diarrhea. The patient had diabetes mellitus and ten years ago underwent hysterectomy due to carcinoma in situ. Additional therapy was not needed. On admission to the hospital, the patient had a temperature of 39 °C. There was mild neck stiffness. She was alert and fully oriented, with a mild truncal and limb ataxia, mild myoclonus and opsoclonus/ocular flutter. Lumbar puncture revealed mononuclear pleocytosis in the cerebrospinal fluid (CSF). Differential etiology ruled out herpes simplex virus, enteroviruses, lysteria, tick borne encephalitis, B.burgdorferi. Paired serology testing confirmed West-Nilevirus. WNV viruria was also confirmed by PCR. The virus was not detected in the CSF. Paraneoplastic/autoimmune etiology of encephylitis was also ruled out as well as malignant disease dissemination. With symptomatic and supportive theray, the patient became afebrile and her headache resolved. Opsoclonus/ocular flutter was expressed for more than a month, after which it gradually abated. Conclusions: West-Nile virus infections have been recorded in Croatia since 2012. The majority of cases have been confirmed in 2018 (more than 50 cases so far). At the Zagreb University Hospital for Infectious Diseases, 12 patients have been treated in the past 6 months with clinical presentation of meningoencephalitis, of whom three died. We present a case of opsoclonus-myoclonus cerebellar syndrome caused by WNV in a 70-year-old patient with favorable disease outcome. To our knowledge, there have been only two other reported cases of opsoclonus myoclonus cerebellar ataxia due to WNV infection.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

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