Fatal West Nile Virus infection after rituximab/fludarabine--induced remission for non-Hodgkin's lymphoma.
West Nile virus (WNV) infections are potentially life threatening in immunocompromised hosts. Currently, the best diagnostic test is serology. Reverse-transcriptase polymerase chain reaction (RT-PCR) testing has a role, but, because WNV is a cell-associated neurotropic virus, RT-PCR results are frequently negative even in cases of active infection. We present a case in which serology results were persistently negative because the patient was immunocompromised following lymphoma treatment. The role of humoral immunity in resolution of WNV is also discussed.
Mawhorter
Steven D
SD
Department of Infectious Disease, Cleveland Clinic Foundation, Cleveland, OH 44195, USA. mawhors@ccf.org
Sierk
Anne
A
Staugaitis
Susan M
SM
Avery
Robin K
RK
Sobecks
Ronald
R
Prayson
Richard A
RA
Procop
Gary W
GW
Yen-Lieberman
Belinda
B
D000911:Antibodies, Monoclonal / Q000008:administration & dosage*; D058846:Antibodies, Monoclonal, Murine-Derived; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D017809:Fatal Outcome; D006801:Humans; D008224:Lymphoma, Follicular / Q000150:complications* / Q000188:drug therapy; D008875:Middle Aged; D012074:Remission Induction; D000069283:Rituximab; D014740:Vidarabine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D014901:West Nile Fever / Q000209:etiology*; D014902:West Nile virus
D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D000970:Antineoplastic Agents; D000069283:Rituximab; D014740:Vidarabine; C024352:fludarabine