title: Natural and nosocomial infection in a patient with West Nile encephalitis and extrapyramidal movement disorders.
abstract: Since its first recognition in North America in 1999, West Nile virus (WNV) has spread rapidly across the continent, but in many communities, rapid diagnostic tests for detection of WNV infection are not fully available. We describe a patient with extrapyramidal movement disorders and changes in the basal ganglia noted on magnetic resonance images that are characteristic of other flavivirus encephalitides and may help in the recognition of patients with West Nile encephalitis. Detailed molecular analysis suggested that, although our patient received a blood transfusion infected with WNV, the virus that caused his initial infection and encephalitis was probably acquired naturally from a mosquito.
authors.affiliation: Department of Pathology, University Texas Medical Branch, Galveston, TX, USA; and Departments of Neurological Science and Medical Microbiology, University of Liverpool, United Kingdom. tsolomon@liv.ac.uk
authors.forename: Tom
authors.initials: T
authors.lastname: Solomon
authors.forename: Ann F
authors.initials: AF
authors.lastname: Fisher
authors.forename: David W C
authors.initials: DW
authors.lastname: Beasley
authors.forename: Pitchaiah
authors.initials: P
authors.lastname: Mandava
authors.forename: Bruno P
authors.initials: BP
authors.lastname: Granwehr
authors.forename: Hans
authors.initials: H
authors.lastname: Langsjoen
authors.forename: Amelia P
authors.initials: AP
authors.lastname: Travassos Da Rosa
authors.forename: Alan D T
authors.initials: AD
authors.lastname: Barrett
authors.forename: Robert B
authors.initials: RB
authors.lastname: Tesh
mesh_terms: D000818:Animals; D001480:Basal Ganglia Diseases / Q000150:complications*; D003428:Cross Infection / Q000635:transmission / Q000821:virology*; D009033:Culicidae; D004199:Disease Vectors; D004660:Encephalitis / Q000209:etiology / Q000821:virology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009069:Movement Disorders / Q000150:complications*; D014901:West Nile Fever / Q000150:complications* / Q000635:transmission; D014902:West Nile virus / Q000145:classification / Q000235:genetics