title: Venezuelan equine encephalitis in a teenager visiting Central America.
abstract: BACKGROUND
  Stupor, coma, and other alterations of consciousness are among the most serious life-threatening emergencies faced by the emergency department physician. When a patient arrives with altered mentation from Central or South America, the usual causes that occur in the United States must be considered; however, other unusual tropical disease must be excluded, such as Venezuelan equine encephalitis (VEE).
  
  
  OBJECTIVE
  This study aimed to review the clinical features of VEE.
  
  
  METHODS
  A 17-year-old female traveled to Belize and developed vomiting, diarrhea, fever, headaches, and myalgias. Over the next few hours, she became disoriented and had a generalized seizure. She was given diazepam, 50% dextrose, phenytoin, mannitol, and vitamin K. A computed tomographic scan of the head was unremarkable. Her parents arranged for a medical air transport. After eliminating other possibilities, she was diagnosed with VEE, which was confirmed in the laboratory. Over the next week, her mental status improved back to her normal neurologic baseline.
  
  
  CONCLUSIONS
  Venezuelan equine encephalitis is an acute viral disease that causes acute illness in equines and humans, with symptoms ranging from a mild, flu-like syndrome to encephalitis or death. Laboratory abnormalities are common and include elevated hepatic transaminases, lymphocytosis, eosinophilia, and thrombocytopenia. Treatment is supportive, and complete recovery is expected within several weeks in most patients.
authors.affiliation: Dallas Regional Medical Center, Mesquite, TX, USA. antonio.muniz2050@gmail.com
authors.forename: Antonio E
authors.initials: AE
authors.lastname: Muñiz
mesh_terms: D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D000914:Antibodies, Viral / Q000032:analysis; D001531:Belize / Q000208:ethnology; D002443:Ceftriaxone / Q000008:administration & dosage; D003937:Diagnosis, Differential; D004666:Encephalitis Virus, Venezuelan Equine / Q000276:immunology*; D004685:Encephalomyelitis, Venezuelan Equine / Q000175:diagnosis* / Q000188:drug therapy / Q000208:ethnology; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007275:Injections, Intravenous; D014195:Travel; D014481:United States / Q000453:epidemiology
chemical_list: D000900:Anti-Bacterial Agents; D000914:Antibodies, Viral; D002443:Ceftriaxone