[Primary infection with West-Nile virus].
BACKGROUND
The recent outbreak of an epidemic of West-Nile fever in New-York revealed this virus' responsibility in some cases of fatal encephalitis. However the clinical manifestations of the infection may be mild as in the case reported herein.


METHODS
A 41-year-old woman without previous medical history presented an acute febrile rash after a trip to Senegal. The course was spontaneously favorable after 5 days, with a biphasic fever at day 3. Reverse passive hemagglutination test confirmed the diagnosis of acute West-Nile fever.


CONCLUSIONS
West-Nile virus, a mosquito-borne flavivirus is usually responsible for a flue-like disease presenting a maculopapular rash in half of the cases. The biphasic evolution of fever is suggestive of the diagnosis. The diagnosis relies on serological tests but cross-reactivities with heterologous flaviviruses may render the interpretation difficult. A rapid recovery is usual but fatal meningoencephalitis can occur especially in the elderly. Treatment is supportive and prevention is limitation of human exposure. West-Nile virus is widely distributed (Africa, Asia, Middle East), but is also endemic in european areas and responsible for seasonal infections.
Estival
J L
JL
Clinique de Dermatologie, Hôpital d'Instruction des Armées Desgenettes, 108, boulevard Pinel, 69275 Lyon Cedex 03.
Skowron
F
F
Dupin
M
M
Combemale
P
P
D000328:Adult; D019353:Endemic Diseases / Q000517:prevention & control / Q000706:statistics & numerical data; D005060:Europe / Q000453:epidemiology; D005076:Exanthema / Q000821:virology*; D005260:Female; D005334:Fever / Q000821:virology*; D006386:Hemagglutination Tests; D006801:Humans; D012075:Remission, Spontaneous; D012621:Seasons; D012675:Senegal / Q000453:epidemiology; D014195:Travel; D014901:West Nile Fever / Q000150:complications* / Q000175:diagnosis* / Q000453:epidemiology / Q000635:transmission