Abstract
A 26-year-old previously healthy man presented with fever, urinary retention, nuchal rigidity, and hyperreflexia but with a clear sensorium. His initial spinal fluid results were consistent with aseptic meningitis from West Nile virus infection, and this was confirmed by serological studies on blood and cerebrospinal fluid. Computed tomography and magnetic resonance imaging studies were unremarkable. He received supportive care and urinary catheterization to prevent bladder injury from overdistension. He was discharged home without recurrence of urinary retention after five days of hospitalization. Therefore, this case report describes the first case of West Nile virus meningitis in a patient with the meningitis-retention syndrome.
Highlights
West Nile virus is one of the mosquito-borne arboviruses in the Flaviviridae family
We are reporting the first case of West Nile virus meningitis with acute urinary retention, consistent with the meningitis-retention syndrome
Magnetic resonance imaging (MRI) of the brain and spinal cord was performed for acute urinary retention workup but was unremarkable (Figures 1(b)–1(d) and Figures 2(a)–2(c))
Summary
West Nile virus is one of the mosquito-borne arboviruses in the Flaviviridae family. The clinical manifestations range from no symptoms in most cases to encephalitis in patients who have West Nile virus neuroinvasive disease. The first case was reported in a febrile woman in 1937 in Uganda. It has spread to the Middle East and Europe and into the United States. In 2012, there was a large outbreak in the United States, in Mississippi, South Dakota, Michigan, California, Louisiana, Oklahoma, Illinois, and Texas. We are reporting the first case of West Nile virus meningitis with acute urinary retention, consistent with the meningitis-retention syndrome
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