Seronegative west nile meningoencephalitis diagnosed by ophthalmologic examination with subsequent seroconversion.
OBJECTIVE
To describe a case of seronegative West Nile virus (WNV) meningoencephalitis definitively diagnosed with ophthalmologic examination and confirmatory repeat laboratory testing.


METHODS
Diagnostic case report.


METHODS
A patient with negative serologic testing for severe viral meningoencephalitis presented with photophobia and blurred vision 2 months after initial presentation.


RESULTS
Examination revealed all the classic ocular findings of WNV. Repeat serologic testing confirmed positive titers for WNV.


CONCLUSIONS
WNV may initially present as a severe meningoencephalitis with negative serology. Ophthalmic examination, particularly in symptomatic patients, may help with diagnosis. The ophthalmologist may play a critical role in evaluation of possible WNV meningoencephalitis.
From the †Cataract and Primary Eye Care Service and Visual Physiology Department, and ‡Retina Service, *Wills Eye Institute, Philadelphia, Pennsylvania.
Justis P
JP
Ehlers
Joseph I
JI
Markoff
Joseph I
JI
Maguire