SHM Converge Scientific Abstract ePoster Gallery-Into the Woods

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West Nile Virus (WNV) is a mosquito-borne single-stranded RNA infection first identified in Uganda in 1937 and now a public health concern in the United States and other regions. Birds are the main reservoir, and transmission occurs mainly through bites from infected Culex mosquitoes. Most infected people have no symptoms, while about 20% develop mild illness such as fever, headache, malaise, and rash. A small proportion develop neuroinvasive disease, including meningitis, encephalitis, or acute flaccid paralysis, especially older adults and those with comorbidities.<br /><br />The case describes a 68-year-old man with cirrhosis who presented after a hiking trip with headache, confusion, sweats, body aches, cough, and a rash. He had possible exposure to mosquitoes, lake water, and poisonous plants. On exam, he was hypotensive and dehydrated, with a macular rash. Labs showed hyponatremia, leukocytosis, and thrombocytopenia. He was initially treated for possible sepsis with antibiotics, but no source of infection was found. Because he declined lumbar puncture, CNS infection was harder to confirm directly, so WNV serology was ordered based on his exposure history and symptoms.<br /><br />His headache improved with IV fluids, antibiotics were stopped, and he recovered quickly over 48 hours. He was discharged with advice to use insect repellent outdoors. One week later, he remained well, and serology confirmed acute WNV infection.<br /><br />The report emphasizes that clinicians should consider WNV in patients with compatible symptoms and mosquito exposure, especially when CSF testing is unavailable. Diagnosis may rely on serology, and treatment is supportive. Prevention includes avoiding mosquito bites and using repellents such as DEET.

Asset Subtitle

Ketino Kobaidze

Meta Tag

Author List Jeffrey Manaloto, Ketino Kobaidze

Category Clinical Vignettes

Concept West Nile Virus

Concept Neuroinvasive Disease

Concept Supportive Care

Concept Mosquito

Concept Mosquito Exposure

Distinguished Non-Finalist

Presenter Organization Emory University School of Medicine

Presenting Author Ketino Kobaidze

Track Adult

Keywords

West Nile Virus

WNV

mosquito-borne infection

Culex mosquitoes

neuroinvasive disease

encephalitis

meningitis

serology

mosquito exposure

DEET repellent

West Nile Virus

Neuroinvasive Disease

Supportive Care

Mosquito

Mosquito Exposure