title: West Nile virus-associated encephalitis in recipients of renal and pancreas transplants: case series and literature review.
abstract: Although West Nile fever is mild in the vast majority of infected persons, there is growing evidence that the disease may be more severe in the immunocompromised population. We describe 3 recipients of kidney or pancreas transplants who developed West Nile fever, 2 of whom had meningoencephalitis. As is the norm when treating serious infections in transplant recipients, a reduction of immunosuppression was pursued for these patients. Despite the severe nature of the disease in 2 patients, all recovered from the disease. The time course of neurologic recovery in the 2 patients with meningoencephalitis is highlighted. We also review the literature on West Nile fever in organ transplant recipients. In areas where West Nile virus is endemic, one must have a high index of suspicion for the illness when dealing with fever in transplant recipients.
authors.affiliation: Department of Surgery, Nebraska Medical Center, Omaha, NE 68198-3285, USA.
authors.forename: Kadiyala V
authors.initials: KV
authors.lastname: Ravindra
authors.forename: Alison G
authors.initials: AG
authors.lastname: Freifeld
authors.forename: Andre C
authors.initials: AC
authors.lastname: Kalil
authors.forename: David F
authors.initials: DF
authors.lastname: Mercer
authors.forename: Wendy J
authors.initials: WJ
authors.lastname: Grant
authors.forename: Jean F
authors.initials: JF
authors.lastname: Botha
authors.forename: Lucile E
authors.initials: LE
authors.lastname: Wrenshall
authors.forename: R Brian
authors.initials: RB
authors.lastname: Stevens
mesh_terms: D000328:Adult; D002675:Child, Preschool; D004660:Encephalitis / Q000209:etiology* / Q000821:virology; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D007165:Immunosuppression Therapy; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D009894:Opportunistic Infections / Q000209:etiology / Q000821:virology; D016035:Pancreas Transplantation / Q000009:adverse effects*; D014180:Transplantation; D014901:West Nile Fever / Q000209:etiology* / Q000821:virology; D014902:West Nile virus