Nipah virus infection with cerebellar dysfunction

Abstract

Background: The Nipah virus (NiV), known to exist in various fruit bats, is associated with one of the deadliest infections affecting human beings. The virus has caused outbreaks in Malaysia, Singapore, Philippines, Bangladesh, and the West Bengal state of India. Pigs were the intermediate hosts during the Malaysian and Singaporean outbreaks and horses in Philippines; while the Indian and Bangladesh outbreaks saw a bat to human followed by human-to-human transmission. The infection is characterized by rapidly progressive encephalitis and acute respiratory distress syndrome, carrying a very high mortality rate. Case Presentation: We present the case of a middle-aged male who presented with fever, vomiting and loose stools, and throat pain. His initial blood investigations were normal. He later developed diplopia, cerebellar symptoms, and segmental sweating. His blood, urine, and throat swab tested positive for NiV. He was started on antivirals but succumbed to death. Conclusion: NiV infection, in humans, presents with a wide spectrum of clinical manifestations, ranging from asymptomatic infection to acute respiratory infection and fatal encephalitis. It is transmitted to humans from animals, such as bats or pigs, or contaminated foods. This was our first experience with NiV; and probably one of the first reported cases from our region. Our experience showed the occurrence of cerebellar symptoms in NiV infection.