scholarly journals West Nile virus encephalitis induced opsoclonus-myoclonus syndrome

2014 ◽  
Vol 6 (2) ◽  
Author(s):  
Chad J. Cooper ◽  
Sarmad Said
Keyword(s):  
West Nile Virus ◽  
Case Reports ◽  
Total Abdominal Hysterectomy ◽  
Altered Mental Status ◽  
Neurological Status ◽  
Abdominal Hysterectomy ◽  
Sudden Onset ◽  
West Nile ◽  
Csf Analysis ◽  
Opsoclonus Myoclonus Syndrome

West Nile virus (WNV) is an arthropod borne neurotropic single stranded RNA flavivirus with <1% developing presenting with neurological disease. Immunocompromised and elderly patients are more prone to developing WNV meningitis or encephalitis. Definitive diagnosis of WNV meningoencephalitis is a combination of clinical suspicion and cerebrospinal fluid (CSF) serology. Forty-eight year old Caucasian female presented with a sudden onset of altered mental status after being found unresponsive. She was confused with intermittent bouts of alertness/lethargy and unintelligible responses to questioning. Her medical problems included endometrial cancer that was in remission after undergoing a total abdominal hysterectomy with bilateral salpingectomy and postoperative chemotherapy with paclitaxel and carboplatin. Pertinent physical examination revealed muscle strength that was significantly decreased, nuchal rigidity and +2 pitting edema of both lower extremities. Computed tomography and magnetic resonance imaging of the brain were negative for any intracranial pathology. CSF analysis was consistent with aseptic meningitis with all CSF serology being negative except for positive WNV antibody. A few days after being admitted she developed involuntary random movements of her eyes and generalized jerking movements (myoclonus). This was determined to be opsoclonus myoclonus syndrome (OMS) induced by the WNV meningoencephalitis. She then received five consecutive days of plasmapheresis with a significant improvement in her neurological status. Opsoclonusmyoclonus syndrome (OMS) is a rare neurological disorder associated with chaotic multidirectional eye movements, myoclonus and less frequently cerebellar ataxia. OMS affects as few as 1 in 10,000,000 people per year. The pathogenesis is not fully understood with the majority of cases of opsoclonus-myoclonus syndrome being idiopathic. According to current medical literature there have only been two previous case reports of opsoclonus myoclonus syndrome associated with WNV encephalitis.

West Nile Virus

2016 ◽  
Author(s):  
Matthew Finn
Keyword(s):  
West Nile Virus ◽  
Rna Virus ◽  
Immunoglobulin M ◽  
Enzyme Linked Immunosorbent Assay ◽  
Mosquito Vector ◽  
West Nile ◽  
Csf Analysis ◽  
Neuroinvasive Disease ◽  
Breeding Grounds ◽  
Arboviral Disease

West Nile virus (WNV) is a single-stranded RNA virus of the Flavivirus family that is transmitted via a mosquito vector, typically causing fever and capable of causing meningoencephalitis. Although mortality is low, it can lead to debilitating neuroinvasive disease in some patients. WNV is a leading cause of domestically-acquired arboviral disease and most commonly occurs in late August and early September. Consider WNV in otherwise unexplained cases of meningitis or encephalitis. Initial testing should consist of cerebrospinal fluid (CSF) analysis and West Nile immunoglobulin M enzyme-linked immunosorbent assay in serum and/or CSF. WNV is a nationally notifiable disease. Prevention remains the key to controlling this disease. Reducing the breeding grounds of the Culex mosquito and using insect repellant to prevent bites are two important strategies.

Adult-onset opsoclonus-myoclonus syndrome due to West Nile Virus treated with intravenous immunoglobulin

2016 ◽  
Vol 23 (1) ◽  
pp. 158-159 ◽  
Author(s):  
Julien Hébert ◽  
David Armstrong ◽  
Nick Daneman ◽  
Jennifer Deborah Jain ◽  
James Perry
Keyword(s):  
West Nile Virus ◽  
Intravenous Immunoglobulin ◽  
Adult Onset ◽  
West Nile ◽  
Opsoclonus Myoclonus Syndrome

scholarly journals Group B Streptococcus Meningitis Following Elective Termination of Pregnancy: Two Case Reports

1995 ◽  
Vol 2 (6) ◽  
pp. 275-278 ◽  
Author(s):  
Mark A. Walker ◽  
S. Gene McNeeley
Keyword(s):  
Case Reports ◽  
Group B Streptococcus ◽  
Altered Mental Status ◽  
Csf Analysis ◽  
Elective Abortion ◽  
Serious Infections ◽  
Physical Examinations ◽  
Group B ◽  
Elective Termination ◽  
Prompt Diagnosis

Background: Although maternal group B streptococcus (GBS) infections are common, serious infections are rare with prompt diagnosis and treatment. We present 2 cases of GBS meningitis occurring 3 and 10 days after elective abortion. In the first patient, GBS meningitis was definitely related to the elective termination. In the second patient, however, no evidence for a causal relationship could be established and can only be presumed.Case: The patients presented to the emergency department with headache, altered mental status, and fever. Their physical examinations were consistent with meningitis and confirmed by cerebrospinal fluid (CSF) analysis. One patient recovered completely and the other developed severe bilateral hearing loss.Conclusion: GBS meningitis is rare, occurring in men and women. When associated with pregnancy, most cases present within 48–72 h of delivery or abortion.

scholarly journals Supraclavicular Lymphadenopathy: Initial Manifestation of Metastasis in Carcinoma of Cervix

2013 ◽  
Vol 2013 ◽  
pp. 1-3 ◽  
Author(s):  
Mutahir A. Tunio ◽  
Mushabbab Al Asiri ◽  
Reham Mohamed ◽  
Sadeq Al-Dandan
Keyword(s):  
Lymph Nodes ◽  
Case Reports ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Initial Manifestation ◽  
Cervical Lymph Nodes ◽  
Supraclavicular Lymph Nodes ◽  
Carcinoma Of Cervix ◽  
Rare Site

Introduction. Carcinoma of cervix rarely metastasizes to cervical lymph nodes and is associated with poor prognosis. To date, only few case reports have been reported in the medical literature. Here, we report a case of this unusual manifestation of carcinoma of cervix.Case Presentation. A 39-year-old Saudi woman who was treated three years ago for bulky IB stage carcinoma of cervix with total abdominal hysterectomy and bilateral salpingo-oophorectomy and adjuvant chemoradiation presented to us during her routine follow-up visit with left supraclavicular lymphadenopathy. Staging workup revealed additional para-aortic nodal and osseous metastases. The biopsy of left supraclavicular mass confirmed the diagnosis of carcinoma of the cervix. Patient was started on chemotherapy and bisphosphonates.Conclusion. Supraclavicular lymph nodes are a rare site of metastasis in carcinoma of cervix, and this can be explained by outlining the drainage of the lymphatic system from the cervix. Supraclavicular lymphadenopathy is associated with variable prognosis.

scholarly journals Retained Foreign Body (Gossypiboma) Following Abdominal Hysterectomy; Removed Per Vaginum-2 Case Reports

2021 ◽  
Vol 3 (5) ◽  
pp. 01-03
Author(s):  
Kalyani Singh
Keyword(s):  
Foreign Body ◽  
Pelvic Pain ◽  
Chronic Pelvic Pain ◽  
Case Reports ◽  
Uterine Fibroids ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Surgical Operation ◽  
Benign Diseases ◽  
Retained Foreign Body

Total abdominal hysterectomy is a quite common open surgical operation accounting for 54% of all benign diseases. Indications are uterine fibroids, adenomyosis/endometriosis, AUB, chronic pelvic pain, cancer of ovaries, uterus or cervix or cancer phobia. It is relatively an uncomplicated operation and easiest when least required.

scholarly journals Two case reports of neuroinvasive West Nile virus infection in the Almaty region, Kazakhstan

IDCases ◽  
2020 ◽  
Vol 21 ◽  
pp. e00872
Author(s):  
Yekaterina O. Ostapchuk ◽  
Andrey V. Zhigailov ◽  
Yuliya V. Perfilyeva ◽  
Anna G. Shumilina ◽  
Lyazzat T. Yeraliyeva ◽  
...  
Keyword(s):  
West Nile Virus ◽  
Virus Infection ◽  
Case Reports ◽  
West Nile Virus Infection ◽  
West Nile

West Nile Neuroinvasive Disease With Atypical CSF Findings: A Case Report

2021 ◽  
pp. 194187442199537
Author(s):  
Devin Simon
Keyword(s):  
West Nile Virus ◽  
Virus Infection ◽  
Rare Complication ◽  
Cauda Equina ◽  
Late Summer ◽  
West Nile Virus Infection ◽  
Inpatient Rehabilitation ◽  
West Nile ◽  
Csf Analysis ◽  
Neuroinvasive Disease

West Nile Neuroinvasive Disease (WNND) is a rare complication of West Nile Virus infection with the capability of mimicking other neurologic diseases. This infection should be considered in the differential diagnosis for patients presenting in the late summer months with altered mentation, fever, and focal neurologic deficits without an otherwise clear etiology. A 63-year-old male presented with acute onset fever, confusion, falls, ataxia, vertical nystagmus, and right leg weakness. Although magnetic resonance imaging of the brain and cervical spine were unremarkable, the lumbar spine revealed enhancement of ventral nerve roots in the cauda equina. Cerebrospinal fluid (CSF) analysis was significant for elevated protein without pleocytosis, which was more suggestive of albuminocytologic dissociation. Both serum and CSF IgM labs testing for West Nile Virus were positive. Despite a 5 day course of immunoglobulin therapy, his symptoms did not significantly improve. He eventually was transferred to inpatient rehabilitation for several days prior to returning home. This case highlights the variable presentations of acute West Nile Virus infection in the rare setting of neuroinvasive disease, which can make diagnosis difficult. The CSF analysis may also not always show results consistent with an acute viral infection, which can make determining the underlying etiology more challenging.

scholarly journals Posterior Reversible Encephalopathy Syndrome : A Rare Cause of Sudden Onset Vision Loss in Pregnancy

2012 ◽  
Vol 6 (2) ◽  
pp. 51-52
Author(s):  
R Chaudhary ◽  
S Dadhich ◽  
J Vyas
Keyword(s):  
Posterior Reversible Encephalopathy Syndrome ◽  
Vision Loss ◽  
Case Reports ◽  
Altered Mental Status ◽  
Sudden Onset ◽  
Cortical Blindness ◽  
Posterior Reversible Encephalopathy ◽  
Visual Deficits ◽  
Reversible Encephalopathy ◽  
In Pregnancy

Posterior Reversible Encephalopathy Syndrome (PRES) is a very rare cause of sudden onset vision loss in pregnancy. There are only few case reports in literature. It is characterized by headache, seizures, altered mental status and visual deficits ranging from visual neglect to cortical blindness. Here a case if PRES has been reported with discussion on its pathophysiology. NJOG 2011 Nov-Dec; 6 (2): 51-52 DOI: http://dx.doi.org/10.3126/njog.v6i2.6759

scholarly journals Three case reports of West Nile virus neuroinvasive disease: lessons from real-life clinical practice

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Camilla Falcinella ◽  
Marina Allegrini ◽  
Lidia Gazzola ◽  
Giovanni Mulè ◽  
Daniele Tomasoni ◽  
...  
Keyword(s):  
West Nile Virus ◽  
Biological Fluids ◽  
Case Reports ◽  
Real Life ◽  
Signs And Symptoms ◽  
West Nile ◽  
Laboratory Findings ◽  
Neuroinvasive Disease ◽  
Transmission Period ◽  
Diagnostic Work

Abstract Background Despite being an uncommon cause of meningoencephalitis, West Nile virus (WNV) recently provoked significant outbreaks throughout Europe. West Nile neuroinvasive disease (WNND) is associated with significant morbidity and mortality in older and compromised individuals, while its diagnosis may be demanding for the clinician. Here discussed are three cases of WNND with a focus on the diagnostic challenges they presented due to atypical clinical presentation and laboratory findings. Case presentation Between July and September 2020 three patients presented to our attention with signs and symptoms compatible with meningoencephalitis. Among routine procedures, they underwent lumbar puncture and imaging. In the absence of microbiological isolates, biological samples were sent for serology and NAATs for WNV. Following diagnosis, the patients gradually recovered and were discharged either home or to rehabilitation facilities. Conclusions The laboratory findings here discussed, in particular CSF parameters, are only partially consistent with those described in the literature, which highlights the need for further research. While serology and NAATs on blood and urine appear the most reliable techniques in the diagnostic work-up of WNND, utility of NAATs on CSF specimens is limited by the kinetics of WNV viremia in biological fluids. This report underlines that WNND should always be included in the differential diagnosis of meningoencephalitis during WNV transmission period.

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