Retrospective Descriptive Analysis of West Nile Neuroinvasive Disease (WNND) in Northwest Louisiana

Pradeep Kumar Mada; Philip Sneed; Gabriel Castano; Maureen Moore; Andrew Stevenson Joel Chandranesan

doi:10.1155/2020/3513859

Retrospective Descriptive Analysis of West Nile Neuroinvasive Disease (WNND) in Northwest Louisiana

Int J Microbiol. 2020 May 8:2020:3513859. doi: 10.1155/2020/3513859. eCollection 2020.

Authors

Pradeep Kumar Mada^{1

2}, Philip Sneed³, Gabriel Castano⁴, Maureen Moore¹, Andrew Stevenson Joel Chandranesan¹

Affiliations

¹ Infectious Diseases, Louisiana State University Health Sciences Center-Shreveport, Shreveport, LA, USA.
² Internal Medicine Department, Texas Health Presbyterian Hospital Dallas, Dallas, TX, USA.
³ Internal Medicine, Louisiana State University Health Sciences Center-Shreveport, Shreveport, LA, USA.
⁴ Department of Pediatrics, University of Texas, San Antonio, TX, USA.

Abstract

Aims: The aim of the study was to describe the presentation characteristics and epidemiology of WNND in Louisiana to improve future recognition of cases and decrease inappropriate antibiotic use. Settings and Design. It was a retrospective descriptive-analytic cohort study. A total of 23 patients with WNND were identified at one tertiary care hospital center in Northwest Louisiana from a retrospective chart review from January 1, 2012 to October 31, 2017.

Results: The median age was 49 years (range: 15-75) for patients with WNND. Of 23 patients diagnosed with WNND, twelve (52%) were diagnosed with encephalitis (WNE), six (26%) were diagnosed with meningitis (WNM), and five (22%) with myelitis (WNME). The common symptoms with WNND were fever in 65%, altered mental status in 61%, headache in 52%, fatigue in 43%, gastrointestinal symptoms in 43%, rigors in 30%, imbalance in 26%, rash in 9%, and seizures in 26% of patients. Most patients presented in the late summer season. The average duration of antibiotics given was six days. The average number of days from the admission to the diagnosis of WNND was nine days (3 to 16 days). Twenty-one (91%) patients survived the infection.

Conclusions: Identifying WNV infection early in its clinical course would help in decreasing inappropriate antibiotic use when patients presented with fever and meningeal symptoms. Performing WNV serology in CSF studies is critical in making the diagnosis.