Neuroinvasive West Nile Virus Presenting as Acute Flaccid Paralysis: A Case Report

Abstract

West Nile virus, a mosquito-borne infection, is known to cause a wide spectrum of clinical manifestations ranging from asymptomatic infection to neuroinvasive disease. Advanced age is a known risk factor for developing neuroinvasive disease and also a prognostic indicator of long-term recovery. We present a case of neuroinvasive West Nile virus infection in a 78-year-old man who presented with acute flaccid paralysis and altered mental status. Positive IgM for West Nile virus in the cerebrospinal fluid confirmed the diagnosis. Individuals presenting with meningitis, encephalitis, and/or acute flaccid paralysis should be assessed for West Nile virus especially if presenting during outbreaks in the summer and fall months. Although treatment remains supportive, prompt diagnosis and reporting of the infection can identify potential outbreaks, emphasize the importance of preventative measures, and promote clinician awareness. J Med Cases. 2019;10(1):21-23 doi: https://doi.org/10.14740/jmc3212