A case of West Nile fever in the Kursk region of Russia

Abstract

Aim: to analyze the features of the clinical course of a case of West Nile fever (WNF) first detected in the Kursk region. Materials and methods. The article presents the first case of WNF detected in the Kursk region, confirmed by detection of pathogen RNA in the PCR test. Results. Patient Ch., 68 years old, was hospitalized to the intensive care unit of the Regional Clinical Infectious Diseases Hospital with severe intoxication, fever up to 39°C, positive meningeal symptoms of Kernig, Brudzinsky, severe neck stiffness. Upon admission, the analysis of peripheral blood showed leukocytosis up to 13.6×109, lymphopenia up to 5%, ESR acceleration up to 20 mm/h. Biochemical analysis revealed a significant increase in CRP, an increase in transaminase activity. In the cerebrospinal fluid, cytosis was noted up to 71 cells per mm3, an increase in protein up to 872 mg/l, the number of neutrophils up to 60%, lymphocytes - up to 40%, and the loss of a delicate plaque. The results of the study revealed high titers of Ig M and Ig G to the antigens of the virus, as well as the detection of WNF virus RNA in the blood and cerebrospinal fluid by PCR. Taking into account the data of the epidemiological anamnesis, clinical symptoms, positive results of ELISA and PCR of blood and cerebrospinal fluid for the causative agent of WNF, the diagnosis was made: West Nile fever with CNS damage, meningeal form (serous meningitis), severe course. Dyscirculatory encephalopathy of complex (dyscirculatory, dysmetabolic) genesis with scattered microsymptomatics. Conclusion. The described clinical case indicates that the WNF causative agent circulates in the Kursk region, which justifies the need for blood and cerebrospinal fluid testing in all patients with hyperthermia of unknown origin, combined with neurological symptoms for the WNF virus.