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1.
Front Public Health ; 9: 628799, 2021.
Article in English | MEDLINE | ID: covidwho-1581140

ABSTRACT

West Nile virus infections have surged across the globe. South Texas, located on the path of bird migration, with Culex quinquefasciatus and other Culex species, and biotic primers that predispose the area to epidemics (floods, amplifying hosts, and lack of mosquito control and prevention) remains a highly endemic area for arbovirus spread. West Nile virus infection ranges from mild febrile illness to severe central nervous system involvement. The purpose of this report is to highlight complex presentations of WNV and how confounding presenting symptoms delay diagnosis. The secondary goal is to describe how pandemics, such as SARS-CoV-2, can overwhelm the system and result in medical decision bias errors.


Subject(s)
COVID-19 , Culex , West Nile Fever , West Nile virus , Animals , Humans , SARS-CoV-2 , West Nile Fever/diagnosis
2.
Transbound Emerg Dis ; 69(2): 221-226, 2022 Mar.
Article in English | MEDLINE | ID: covidwho-1546411

ABSTRACT

West Nile Virus (WNV) infections are increasingly detected in birds and horses in central Europe, with the first mosquito-borne autochthonous human infection detected in Germany in 2019. Human infections are typically asymptomatic, with occasional severe neurological disease. Because of a low number of cases in central Europe, awareness regarding potential cases is low and WNV diagnostic testing is not routine. We tested cerebrospinal fluid (CSF) samples from unsolved encephalitis and meningitis cases from Berlin from 2019 to 2020, and describe a WNV-encephalitis case in a 33-year-old kidney transplant recipient. The infectious course was resolved by serology, RT-PCR and sequencing of stored samples. Phylogenetic sequence analysis revealed a close relationship of the patient's WNV strain to German sequences from 2019 and 2020. A lack of travel history and patient self-isolation during the SARS-CoV-2 pandemic suggest the infection was acquired in the patient's home or garden. Serological tests of four people sharing the living space were negative. Retrospective RT-PCR and WNV-IgM testing of 671 CSF samples from unsolved encephalitis and meningitis cases from Berlin detected no additional infections. The recent increase of WNV cases illustrates the importance of considering WNV in cases of meningoencephalitis, especially in immunocompromised patients, as described here. Proper education and communication and a revised diagnostic strategy will help to raise awareness and to detect future WNV infections.


Subject(s)
Kidney Transplantation , West Nile Fever , West Nile virus , Adult , Humans , West Nile Fever/diagnosis
3.
Am J Trop Med Hyg ; 104(5): 1716-1718, 2021 Mar 29.
Article in English | MEDLINE | ID: covidwho-1302675

ABSTRACT

We present a fatal case of West Nile virus meningoencephalomyelitis initially misdiagnosed as COVID-19 in a 63-year-old Egyptian woman with a previous diagnosis of systemic lupus erythematosus. The patient's medical history and immunosuppressive therapy, as well as the COVID-19 pandemic, substantially broadened the differential diagnosis of her encephalitis.


Subject(s)
COVID-19/diagnosis , Lupus Erythematosus, Systemic/complications , SARS-CoV-2 , West Nile Fever/diagnosis , COVID-19/complications , Diagnostic Errors , Fatal Outcome , Female , Humans , Middle Aged , West Nile Fever/mortality
4.
J Am Board Fam Med ; 34(3): 661-662, 2021.
Article in English | MEDLINE | ID: covidwho-1259324

ABSTRACT

The ever-evolving pandemic of Coronavirus disease 2019 (COVID-19) has the potential to drown out other viruses continuing to infect communities. To highlight this, we present 2 cases of fatal West Nile virus neuroinvasive disease that occurred within 2 weeks of each other. Since the first positive case of West Nile virus in the United States, there have been 2 epidemics in the past 2 decades, most often occurring in regions of North Texas and Southern California, which have been areas of high-incidence for COVID-19. It is important for the health care provider to recognize diagnostic biases and maintain broad differentials for the patient presenting with fever and other symptoms associated with COVID-19.


Subject(s)
COVID-19 , West Nile Fever , COVID-19/diagnosis , COVID-19/epidemiology , California/epidemiology , Diagnosis, Differential , Humans , Pandemics , Texas/epidemiology , West Nile Fever/diagnosis , West Nile Fever/epidemiology
5.
Am J Trop Med Hyg ; 104(5): 1716-1718, 2021 Mar 29.
Article in English | MEDLINE | ID: covidwho-1158425

ABSTRACT

We present a fatal case of West Nile virus meningoencephalomyelitis initially misdiagnosed as COVID-19 in a 63-year-old Egyptian woman with a previous diagnosis of systemic lupus erythematosus. The patient's medical history and immunosuppressive therapy, as well as the COVID-19 pandemic, substantially broadened the differential diagnosis of her encephalitis.


Subject(s)
COVID-19/diagnosis , Lupus Erythematosus, Systemic/complications , SARS-CoV-2 , West Nile Fever/diagnosis , COVID-19/complications , Diagnostic Errors , Fatal Outcome , Female , Humans , Middle Aged , West Nile Fever/mortality
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