title: Rhabdomyolysis in a patient with West Nile encephalitis and flaccid paralysis.
abstract: West Nile Virus (WNV), a flavivirus, was first documented in the United States by the Center for Disease Control in 1999. WNV has been associated with a variety of clinical features from a subclinical febrile illness to a neuroinvasive disease. Rhabdomyolysis, however, has not been a clinically well-described occurrence during WNV illness. We report a case of a 56 year-old African-American male with WNV infection who developed neuroinvasive encephalitis, flaccid paralysis, and rhabdomyolysis. During his illness, creatinine kinase (CK) values peaked at 45,276 U/L. We discuss the temporal relationship of the development of rhabdomyolysis, the course of his paralytic illness, imaging results, and present supporting evidence that rhabdomyolysis was not a sequel of another clinical condition. With the increasing spread of WNV, it is important to recognize rhabdomyolysis and flaccid paralysis as important manifestations of neuroinvasive WNV infection.
authors.affiliation: Department of Medicine, University of Tennessee Health Science Center, Memphis 38163, USA.
authors.forename: Malini
authors.initials: M
authors.lastname: Gupta
authors.forename: Mehrdad
authors.initials: M
authors.lastname: Ghaffari
authors.forename: Amado X
authors.initials: AX
authors.lastname: Freire
mesh_terms: D015415:Biomarkers / Q000097:blood; D003402:Creatine Kinase / Q000097:blood; D003952:Diagnostic Imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D010243:Paralysis / Q000175:diagnosis* / Q000209:etiology*; D012206:Rhabdomyolysis / Q000175:diagnosis* / Q000209:etiology*; D014901:West Nile Fever / Q000150:complications* / Q000175:diagnosis*
chemical_list: D015415:Biomarkers; D003402:Creatine Kinase