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Case Reports
. 2019 Aug 22;36(5):287-289.
doi: 10.4274/balkanmedj.galenos.2019.2018.12.74. Epub 2019 Jun 20.

Neuroinvasive West Nile Virus Disease in an Elderly Patient with Diffuse Large B-Cell Lymphoma Treated with R-CHOP Therapy: A Case Report

Barış Arslan  1 , Hasan Murat Gündüz  2 , Nurdan Ünlü  1 , Gökhan Çavuş  3 , Dilek Menemenlioğlu  4
Affiliations
Case Reports

Neuroinvasive West Nile Virus Disease in an Elderly Patient with Diffuse Large B-Cell Lymphoma Treated with R-CHOP Therapy: A Case Report

Barış Arslan et al. Balkan Med J. .

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: West Nile virus; Lymhoma; Turkey.

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Conflict of interest statement

Conflict of Interest: No conflict of interest was declared by the authors.

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