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 languageEnglish (US)
Pages (from-to)459-464
Number of pages6
JournalTransplant Infectious Disease
Volume12
Issue number5
DOIs
StatePublished - Oct 1 2010

Fingerprint

West Nile virus
Encephalitis
Pancreas
Kidney
Nucleic Acids
Immunoglobulin M
RNA
Flavivirus
Virus Diseases
Transplant Recipients
Immunosuppression
Viruses

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

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title = "Seronegative naturally acquired West Nile virus encephalitis in a renal and pancreas transplant recipient",
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.",
keywords = "Diagnosis, Immunosuppression, Nucleic acid amplification testing, Renal and pancreas transplant, Serology, Transplant, West Nile virus",
author = "Koepsell, {Scott A} and Freifeld, {Alison Gail} and Sambol, {Anthony R.} and McComb, {Rodney D} and Kazmi, {S. A.}",
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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

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