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Case Reports
. 2024 Jan 7:45:117-122.
doi: 10.1016/j.jdcr.2023.12.016. eCollection 2024 Mar.

West Nile virus encephalitis presenting with a vesicular dermatitis

Eunice E Lee  1 , Maria Mejia  1 , Loderick A Matthews  1 , Francesca Lee  2 , Kishan M Shah  1 , John W Schoggins  3 , Travis W Vandergriff  1   4 , Kim B Yancey  1 , Cristina Thomas  1   2 , Richard C Wang  1
Affiliations
Case Reports

West Nile virus encephalitis presenting with a vesicular dermatitis

Eunice E Lee et al. JAAD Case Rep. .
No abstract available

Keywords: West Nile virus; encephalitis; flavivirus; immunofluorescence; immunohistochemistry; vesiculobullous eruption.

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Conflict of interest statement

None disclosed.

Figures

Fig 1
Fig 1
Clinical presentation of (A) initial day 4 and (B) evolving day 6 skin lesions in patient diagnosed with West Nile virus encephalitis. Early lesions were pink macules and papules on the back and chest. Late lesions included erythematous papules and vesicles on the back, chest, and extremities.
Fig 2
Fig 2
Biopsy revealed an acantholytic intraepidermal vesicle with focal dyskeratosis and a mixed infiltrate in the papillary dermis. (Original magnifications: A, ×100; B, ×200; C, ×200; D, ×400).
Fig 3
Fig 3
Immunofluorescence and immunohistochemical (IHC) staining for West Nile virus (WNV) NS1 glycoprotein. A, Biopsies were incubated with an antibody against WNV nonstructural glycoprotein NS1 (9NS1) and 4′,6-diamidino-2-phenylindole (DAPI), which highlights nuclei. Biopsy from perilesional skin from a vesicle revealed a intracellular and fibrillar staining pattern from patient with WNV which was absent in normal-appearing skin obtained from a tissue repository. B, IHC staining of WNV NS1 protein revealed robust intracellular staining of keratinocytes in lesional biopsy from patient with WNV which was absent in normal-appearing skin obtained from a tissue repository.
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