ISSN : 2146-3123
E-ISSN : 2146-3131

Neuroinvasive West Nile Virus Disease in an Elderly Patient with Diffuse Large B-Cell Lymphoma Treated with R-CHOP Therapy: A Case Report
Barış Arslan1, Hasan Murat Gündüz2, Nurdan Ünlü1, Gökhan Çavuş3, Dilek Menemenlioğlu4
1Clinic of Anesthesia and Intensive Care, Adana City Training and Research Hospital, Adana, Turkey
2Department of Anesthesia and Intensive Care, Çukurova University School of Medicine, Adana, Turkey
3Department of Neurosurgery, Adana City Training and Research Hospital, Adana, Turkey
4Medical Microbiology Specialist, Public Health General Directorate, Microbiology Reference Laboratories and Biological Products Department, National Arboviruses and Viral Zoonoses Laboratory, Ankara, Turkey
DOI : 10.4274/balkanmedj.galenos.2019.2018.12.74
Pages : 287-289

Abstract

Background: West Nile virus is an arthropod-borne virus (arbovirus) and emerging cause of significant illness in European and Mediterranean countries. West Nile virus infection can cause severe and potentially fatal neurological illnesses, including encephalitis, meningitis, and acute flaccid paralysis. Additionally, immunosuppression, alcohol abuse, old age, and diabetes mellitus are common factors associated with West Nile neuroinvasive disease.
Case Report: In August 2018, a 60-year-old male patient with a history of diffuse large B-cell lymphoma initially presented with symptoms including abdominal pain and distention, nausea, and vomiting. Three days after open abdominal surgery due to adhesive small bowel obstruction, he developed fever, prominent tremors, and rapidly progressing flaccid paralysis. The identification of West Nile virus RNA in the serum sample led to the diagnosis of West Nile neuroinvasive disease.
Conclusion: Clinicians should evaluate patients with acute flaccid paralysis for the evidence of West Nile neuroinvasive disease. It is particularly important for healthcare providers to consider West Nile neuroinvasive disease in the differential diagnosis of aseptic meningitis, encephalitis, and acute paralysis cases, especially in endemic areas.

Keywords : Lymhoma, Turkey, West Nile virus
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