Abstract
West Nile virus (WNV), a single-stranded RNA flavivirus, has spread across the United States since arriving in 1999. While asymptomatic or self-limited in a majority of patients, WNV can cause a severe neuroinvasive disease, which occurs more often in transplant recipients with chronic immunosuppression. Diagnosis of acute WNV infection usually relies on serologic identification of immunoglobulin M (IgM) specific for the virus. We report a fatal case of naturally acquired WNV encephalitis in a renal and pancreas transplant recipient who was seronegative for WNV-specific IgM but had detectable WNV RNA by nucleic acid amplification testing (NAAT) several weeks after the onset of symptoms. This case demonstrates the importance of using both serologic assays and NAAT for WNV in transplant recipients with the clinical suspicion of encephalitis.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 459-464 |
| Number of pages | 6 |
| Journal | Transplant Infectious Disease |
| Volume | 12 |
| Issue number | 5 |
| DOIs | |
| State | Published - Oct 1 2010 |
Fingerprint
Keywords
- Diagnosis
- Immunosuppression
- Nucleic acid amplification testing
- Renal and pancreas transplant
- Serology
- Transplant
- West Nile virus
ASJC Scopus subject areas
- Infectious Diseases
- Transplantation
Cite this
Seronegative naturally acquired West Nile virus encephalitis in a renal and pancreas transplant recipient. / Koepsell, Scott A; Freifeld, Alison Gail; Sambol, Anthony R.; McComb, Rodney D; Kazmi, S. A.
In: Transplant Infectious Disease, Vol. 12, No. 5, 01.10.2010, p. 459-464.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Seronegative naturally acquired West Nile virus encephalitis in a renal and pancreas transplant recipient
AU - Koepsell, Scott A
AU - Freifeld, Alison Gail
AU - Sambol, Anthony R.
AU - McComb, Rodney D
AU - Kazmi, S. A.
PY - 2010/10/1
Y1 - 2010/10/1
N2 - West Nile virus (WNV), a single-stranded RNA flavivirus, has spread across the United States since arriving in 1999. While asymptomatic or self-limited in a majority of patients, WNV can cause a severe neuroinvasive disease, which occurs more often in transplant recipients with chronic immunosuppression. Diagnosis of acute WNV infection usually relies on serologic identification of immunoglobulin M (IgM) specific for the virus. We report a fatal case of naturally acquired WNV encephalitis in a renal and pancreas transplant recipient who was seronegative for WNV-specific IgM but had detectable WNV RNA by nucleic acid amplification testing (NAAT) several weeks after the onset of symptoms. This case demonstrates the importance of using both serologic assays and NAAT for WNV in transplant recipients with the clinical suspicion of encephalitis.
AB - West Nile virus (WNV), a single-stranded RNA flavivirus, has spread across the United States since arriving in 1999. While asymptomatic or self-limited in a majority of patients, WNV can cause a severe neuroinvasive disease, which occurs more often in transplant recipients with chronic immunosuppression. Diagnosis of acute WNV infection usually relies on serologic identification of immunoglobulin M (IgM) specific for the virus. We report a fatal case of naturally acquired WNV encephalitis in a renal and pancreas transplant recipient who was seronegative for WNV-specific IgM but had detectable WNV RNA by nucleic acid amplification testing (NAAT) several weeks after the onset of symptoms. This case demonstrates the importance of using both serologic assays and NAAT for WNV in transplant recipients with the clinical suspicion of encephalitis.
KW - Diagnosis
KW - Immunosuppression
KW - Nucleic acid amplification testing
KW - Renal and pancreas transplant
KW - Serology
KW - Transplant
KW - West Nile virus
UR - http://www.scopus.com/inward/record.url?scp=78650437180&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=78650437180&partnerID=8YFLogxK
U2 - 10.1111/j.1399-3062.2010.00530.x
DO - 10.1111/j.1399-3062.2010.00530.x
M3 - Article
C2 - 20576021
AN - SCOPUS:78650437180
VL - 12
SP - 459
EP - 464
JO - Transplant Infectious Disease
JF - Transplant Infectious Disease
SN - 1398-2273
IS - 5
ER -