West Nile virus - Revision history

Elcatracho: /* Virolgy */

2021-01-15T08:06:29Z

Virolgy

← Older revision		Revision as of 08:06, 15 January 2021
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	==Background==		==Background==
	===Virolgy===		===Virolgy===
	[[File: Westnile.jpg\|thumb\|Micrograph of west nile virus. Source: https://pixnio.com/science/microscopy-images/west-nile-disease/micrograph-of-the-west-nile-virus]]		[[File:Westnile.jpg\|thumb\|Micrograph of west nile virus. Source: https://pixnio.com/science/microscopy-images/west-nile-disease/micrograph-of-the-west-nile-virus]]
	*RNA virus		*RNA virus
	*Virus family associated with St Louise encephalitis, Japanese encephalitis, Murray Vallen enceph, and Kunjin enceph		*Virus family associated with St Louise encephalitis, Japanese encephalitis, Murray Vallen enceph, and Kunjin enceph

Elcatracho: /* Virolgy */

2021-01-15T08:05:58Z

Virolgy

← Older revision		Revision as of 08:05, 15 January 2021
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	==Background==		==Background==
	===Virolgy===		===Virolgy===
			[[File: Westnile.jpg\|thumb\|Micrograph of west nile virus. Source: https://pixnio.com/science/microscopy-images/west-nile-disease/micrograph-of-the-west-nile-virus]]
	*RNA virus		*RNA virus
	*Virus family associated with St Louise encephalitis, Japanese encephalitis, Murray Vallen enceph, and Kunjin enceph		*Virus family associated with St Louise encephalitis, Japanese encephalitis, Murray Vallen enceph, and Kunjin enceph

Elcatracho: /* Epidemiology */

2021-01-15T08:03:15Z

Epidemiology

← Older revision		Revision as of 08:03, 15 January 2021
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	===Epidemiology===		===Epidemiology===
			[[File: Global_distribution_of_West_Nile_virus-CDC.gif\|thumb\|Global Distribution of West Nile Virus. Source: CDC]]
	*Found in Africa, Middle East, Russia, Australia		*Found in Africa, Middle East, Russia, Australia
	*First appeared in eastern US in 1999 but now found nationwide<ref>West Nile virus. Centers for Disease Control and Prevention website. Accessed January 15, 2021.</ref>		*First appeared in eastern US in 1999 but now found nationwide<ref>West Nile virus. Centers for Disease Control and Prevention website. Accessed January 15, 2021.</ref>
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	**Blood transfusion		**Blood transfusion
	**Percutaneous lab infection		**Percutaneous lab infection
	~~[[File: Global_distribution_of_West_Nile_virus-CDC.gif\|thumb\|Global Distribution of West Nile Virus. Source: CDC]]~~

	==Clinical Features==		==Clinical Features==

Elcatracho: /* Background */

2021-01-15T08:02:42Z

Background

← Older revision		Revision as of 08:02, 15 January 2021
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	**Blood transfusion		**Blood transfusion
	**Percutaneous lab infection		**Percutaneous lab infection
			[[File: Global_distribution_of_West_Nile_virus-CDC.gif\|thumb\|Global Distribution of West Nile Virus. Source: CDC]]

	==Clinical Features==		==Clinical Features==

Elcatracho: /* See Also */

2021-01-15T07:55:57Z

Elcatracho: /* Disposition */

2021-01-15T07:55:32Z

Disposition

← Older revision		Revision as of 07:55, 15 January 2021
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	==Disposition==		==Disposition==
	Admit		Admit

			==External Links==
			https://www.cdc.gov/westnile/index.html

	==See Also==		==See Also==

Elcatracho: /* Epidemiology */

2021-01-15T07:54:37Z

Epidemiology

← Older revision		Revision as of 07:54, 15 January 2021
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	===Epidemiology===		===Epidemiology===
	*Found in Africa, Middle East, Russia, Australia,		*Found in Africa, Middle East, Russia, Australia
			*First appeared in eastern US in 1999 but now found nationwide<ref>West Nile virus. Centers for Disease Control and Prevention website. Accessed January 15, 2021.</ref>
	*Most human infections occur in August and Sept but can happen from May to Dec		*Most human infections occur in August and Sept but can happen from May to Dec
	*Human Transmission		*Human Transmission

ClaireLewis at 00:25, 2 October 2019

2019-10-02T00:25:40Z

← Older revision		Revision as of 00:25, 2 October 2019
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	*2-14 day incubation		*2-14 day incubation
	*Illness for 3-6 days		*Illness for 3-6 days
	*Malaise, anorexia, nausea/[[vomiting]], eye pain, [[headache]], myalgia, rash		*Malaise, anorexia, nausea/[[vomiting]], [[eye pain]], [[headache]], [[myalgia]], [[rash]]
	*20% of infected patients get West Nile fever		*20% of infected patients get West Nile fever
	*<1% get severe neuro problem- [[encephalitis]], [[meningitis]], acute flaccid paralysis		*<1% get severe neuro problem- [[encephalitis]], [[meningitis]], acute flaccid [[weakness\|paralysis]]
	*Can also get movement disorder- tremor, myoclonus, Parkinsonism, bradykinesia		*Can also get movement disorder- [[tremor]], myoclonus, Parkinsonism, bradykinesia
	*Can also have cranial nerve, optic neuritis, seizure		*Can also have [[cranial nerve palsies\|cranial nerve involvement]], [[optic neuritis]], [[seizure]]
	*[[Myocarditis]], [[pancreatitis]], fulminant hepatitis		*[[Myocarditis]], [[pancreatitis]], fulminant hepatitis
	*Acute flaccid paralysis		*Acute flaccid [[paralysis]]
	**Weakness can affect upper or lower limbs and can happen without meningitis		**Weakness can affect upper or lower limbs and can happen without meningitis
	**Can become hypo/areflexic, acute bowel and bladder dysfunction, absence of pain, or sensory changes		**Can become hypo/areflexic, acute bowel and bladder dysfunction, absence of pain, or sensory changes
	**CSF has increased protein and pleocytosis		**[[LP\|CSF]] has increased protein and pleocytosis
	**Similar polio with destruction of spinal anterior horn cells as ~~apposed~~ to GBS		**Similar to [[polio]] with destruction of spinal anterior horn cells as opposed to GBS

	==Differential Diagnosis==		==Differential Diagnosis==
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	*[[SAH]]		*[[SAH]]
	*[[Lyme disease]]		*[[Lyme disease]]
	*Brain abscess		*[[Brain abscess]]
	*Bacterial [[endocarditis]]		*Bacterial [[endocarditis]]
	*Toxic / metabolic encephalopathy		*Toxic / metabolic encephalopathy
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	==Evaluation==		==Evaluation==
	*~~Perf wbc~~ count normal or sl elevated		*WBC count normal or slightly elevated
	*CSF - pleocytosis with lymphocyte predominance and elevated protein		*[[LP\|CSF]] - pleocytosis with lymphocyte predominance and elevated protein
	*CT head ~~neg~~		*[[CT head]]- negative
	*MRI brain usually ~~neg~~ but can show focal lesion in pons, basal gang, thal		*[[brain MRI\|MRI brain]] usually negative but can show focal lesion in pons, basal gang, thal
	*Confirmation by blood or CSF IgM		*Confirmation by blood or [[LP\|CSF]] IgM
	**IgM does not cross BBB so CSF IgM indicated CNS infc		**IgM does not cross BBB so CSF IgM indicated CNS infc
	*False positive is recently vaccinated for yellow fever, Jap enceph, or recently infected with relate flavivirus- St Louse, Dengue		*False positive is recently vaccinated for yellow fever, Jap enceph, or recently infected with relate flavivirus- St Louse, Dengue
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	*4- 18% fatality		*4- 18% fatality
	*Older age greatest risk for death		*Older age greatest risk for death
	*Risk for poor neuro outcome and death- encephalitis, severe muscle weakness, ~~ams~~, DM, immune suppression		*Risk for poor neuro outcome and death- [[encephalitis]], severe muscle [[weakness]], [[AMS]], [[DM]], immune suppression
	*Can have significant morbidity and loss of function even in those patients that survive and are discharged to home		*Can have significant morbidity and loss of function even in those patients that survive and are discharged to home
	*Parkinsons, tremor, gait, balance ~~problem~~ most common neuro ~~finding~~ after dc to home		*[[parkinson's disease\|Parkinsons]], [[tremor]], [[ataxia\|gait instability]], balance problems are most common neuro findings after discharge to home
	*Initial severe encephalopathy did not mean poor neuro outcome		*Initial severe encephalopathy did not mean poor neuro outcome
	*Acute flaccid paralysis typically has very poor recovery		*Acute flaccid paralysis typically has very poor recovery
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	[[Category:ID]]		[[Category:ID]]
			[[Category:Neurology]]

Rossdonaldson1: Text replacement - "assoc " to "associated "

2016-08-24T20:44:37Z

Text replacement - "assoc " to "associated "

← Older revision		Revision as of 20:44, 24 August 2016
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	===Virolgy===		===Virolgy===
	*RNA virus		*RNA virus
	*Virus family ~~assoc~~ with St Louise encephalitis, Japanese encephalitis, Murray Vallen enceph, and Kunjin enceph		*Virus family associated with St Louise encephalitis, Japanese encephalitis, Murray Vallen enceph, and Kunjin enceph
	*2 lineage of WNV - only lineage 1 associated with human disease originating in Middle East/Israel		*2 lineage of WNV - only lineage 1 associated with human disease originating in Middle East/Israel

Neil.m.young: Text replacement - "==Diagnosis==" to "==Evaluation=="

2016-07-27T01:57:48Z

Text replacement - "==Diagnosis==" to "==Evaluation=="

← Older revision		Revision as of 01:57, 27 July 2016
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	{{AMS and fever DDX}}		{{AMS and fever DDX}}

	==~~Diagnosis~~==		==Evaluation==
	*Perf wbc count normal or sl elevated		*Perf wbc count normal or sl elevated
	*CSF - pleocytosis with lymphocyte predominance and elevated protein		*CSF - pleocytosis with lymphocyte predominance and elevated protein

← Older revision		Revision as of 07:55, 15 January 2021
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	*[[Encephalitis]]		*[[Encephalitis]]

			==References==
	[[Category:ID]]		[[Category:ID]]
	[[Category:Neurology]]		[[Category:Neurology]]