title: Hyperimmune gammaglobulin for the treatment of West Nile virus encephalitis.
abstract: BACKGROUND
  West Nile virus, the etiologic agent of West Nile fever, is an emerging mosquito-borne disease. WNV was recognized as a cause of severe human meningoencephalitis in elderly patients during outbreaks in various parts of the world.
  
  
  OBJECTIVE
  To analyze WNV encephalitis therapy and its outcome after prescribing hyperimmune gammaglobulin therapy.
  
  
  METHODS
  Eight subjects with WNV encephalitis were treated with supportive therapy and 5 days of IVIG 0.4 g/kg/day containing high WNV antibodies obtained from healthy blood donors.
  
  
  RESULTS
  Patients who were treated with IVIG as soon as possible exhibited an improvement in their symptoms. All subjects presented with high fever, progressive confusion and headaches, nausea and vomiting. The Glasgow Coma Screen for six patients ranged between 8 and 13 and all were discharged with a score of 15. The remaining two subjects died during their hospitalization.
  
  
  CONCLUSIONS
  In severe WNV infection, where the disease affects the central and/or peripheral nervous system, early intervention with IVIG together with supportive treatment is recommended.
authors: Departments of Internal Medicine B, Rambam Health Care Campus and Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
authors: Badira
authors: B
authors: Makhoul
authors: Eyal
authors: E
authors: Braun
authors: Moshe
authors: M
authors: Herskovitz
authors: Rawi
authors: R
authors: Ramadan
authors: Salim
authors: S
authors: Hadad
authors: Krivoy
authors: K
authors: Norberto
mesh_terms: D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use*; D007155:Immunologic Factors / Q000627:therapeutic use*; D007902:Length of Stay; D008297:Male; D014901:West Nile Fever / Q000628:therapy*
chemical_list: D016756:Immunoglobulins, Intravenous; D007155:Immunologic Factors