Last reviewed: 30 Sep 2024
Last updated: 10 Aug 2023
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
Full details
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
Full details
Risk factors
- living in/visiting areas with high West Nile virus activity
- mosquito bites
- blood transfusion
- organ transplant
- needlestick injuries
Full details
Diagnostic tests
1st tests to order
- serology
- cerebrospinal fluid (CSF) analysis
- complete blood count
- serum electrolytes
- liver function tests
- serum amylase/lipase
Full details
Tests to consider
- MRI brain
- CT head
- viral culture or reverse transcriptase-polymerase chain reaction (RT-PCR)
Full details
Treatment algorithm
ACUTE
West Nile fever
West Nile neuroinvasive disease
Contributors
Authors
Bruce Y. Lee, MD, MBA
Professor of Health Policy and Management
Executive Director
Center for Advanced Technology and Communication for Health (CATCH)
Public Health Informatics Computational and Operation Research (PHICOR)
City University of New York (CUNY)
New York
NY
Disclosures
BYL declares that he has no competing interests.
Peer reviewers
Susan Stramer, PhD
Executive Scientific Officer
American Red Cross
Gaithersburg
MD
Disclosures
SS declares that she has no competing interests.
Differentials
- Herpes simplex encephalitis
- St. Louis encephalitis
- Eastern equine encephalitis
More DifferentialsGuidelines
- West Nile virus: information for healthcare providers
- West Nile virus surveillance and control guidelines
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