Last reviewed: March 2019
Last updated: November  2018

Summary

Definition

History and exam

Key diagnostic factors

  • fever of sudden onset
  • malaise
  • myalgia
  • arthralgia
  • pharyngitis
  • anorexia
  • abdominal pain
  • visual disturbances
  • headache
  • rash
  • lymphadenopathy
  • conjunctival injection
  • multifocal chorioretinal lesions
  • chorioretinitis and inflammatory vitritis
  • seizures
  • respiratory distress
  • jaundice
  • epigastric tenderness
  • mild confusion
  • disorientation
  • stupor/coma
  • neck stiffness
  • Kernig sign
  • Brudzinski sign
  • muscle paralysis
  • parkinsonism
  • ataxia
  • myoclonus
  • tremors

Other diagnostic factors

  • nausea/vomiting
  • generalized muscle weakness
  • splenomegaly
  • retinal hemorrhages
  • chest pain, dyspnea, palpitations
  • photophobia
  • depression
  • loss of memory
  • bowel and bladder dysfunction
  • cranial nerve palsies

Risk factors

  • living in/visiting areas with high West Nile virus activity
  • mosquito bites
  • blood transfusion
  • organ transplant
  • needlestick injuries

Diagnostic investigations

1st investigations to order

  • serology
  • cerebrospinal fluid (CSF) analysis
  • complete blood count
  • serum electrolytes
  • liver function tests
  • serum amylase/lipase
Full details

Investigations to consider

  • MRI brain
  • CT head
  • viral culture or reverse transcriptase-polymerase chain reaction (RT-PCR)
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Bruce Y. Lee

Associate Professor of International Health

Director

Global Obesity Prevention Center

Director of Operations Research

International Vaccine Access Center (IVAC)

Johns Hopkins School of Public Health

Baltimore

MD

Disclosures

BYL declares that he has no competing interests.

Peer reviewers VIEW ALL

Executive Scientific Officer

American Red Cross

Gaithersburg

MD

Disclosures

SS declares that she has no competing interests.

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