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West Nile Virus Disease > Diagnosis Author: Amy V. Bode, MD, MSPH; James J. Sejvar, MD; Anthony A. Marfin, MD, MPH
Editorial changes - 2009-06-03
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Rationale:

  • Enhancement of leptomeninges with or without periventricular areas may support diagnosis in approximately 30% of patients.

Evidence:

  • MRI findings in 31% of imaged patients showed periventricular and/or leptomeningeal enhancement in case series conducted in New York and New Jersey in 1999 and 2000, respectively (26; 32).
  • MRI showed bilateral focal lesions in basal ganglia, thalamus, and pons in two patients with WNV encephalitis and spinal findings consistent with meningitis in two patients with acute flaccid paralysis (30).

Comments:

  • Up to 32% of patients have abnormal CT scans of the brain with atrophy or pre-existing ischemic change but no evidence of acute disease; therefore, these findings probably represent pre-existing conditions (24; 26; 32). CT scan of the head is thus useful to exclude other conditions.

FAQs
Amy V. Bode, MD, MSPH has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations. Anthony A. Marfin, MD, MPH has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations. James J. Sejvar, MD has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations. Yanlin Tang, PhD, editorial consultant, has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations.
Steven E. Weinberger, MD, FACP, Acting Editor, PIER, has stock holdings in Glaxosmithkline and Abbott.

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