West Nile virus meningitis in a chronic immunosuppressed patient with rheumatoid arthritis.
The clinical presentation of West Nile virus (WNV) can be severe in immunosuppressed patients. A 65-year-old with steroid-dependent rheumatoid arthritis on infliximab and methotrexate presented with meningitis and profound muscular weakness. Serum WNV IgM and IgG antibody were positive. WNV should be included in the differential diagnosis of neurological symptoms in peak months.
Batsis
John A
JA
Department of Medicine, Mayo School of Graduate Medical Education, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN 55905, USA. batsis.john@mayo.edu
Phy
Michael P
MP
D000368:Aged; D000818:Animals; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D018501:Antirheumatic Agents / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000188:drug therapy / Q000276:immunology*; D006801:Humans; D016867:Immunocompromised Host; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D000069285:Infliximab; D008297:Male; D008587:Meningitis, Viral / Q000175:diagnosis / Q000276:immunology* / Q000821:virology; D008727:Methotrexate / Q000627:therapeutic use; D014901:West Nile Fever / Q000175:diagnosis / Q000276:immunology*; D014902:West Nile virus
D000911:Antibodies, Monoclonal; D018501:Antirheumatic Agents; D007166:Immunosuppressive Agents; D000069285:Infliximab; D008727:Methotrexate