West-Nile virus encephalitis in an immunocompetent pediatric patient: successful recovery

Research output: Contribution to journalArticle

Abstract

BACKGROUND: West Nile virus (WNV) is a mosquito-borne RNA virus belonging to the Flaviviridae family. Symptomatic infection happens in only about 20% of the cases, while WNV neuroinvasive disease (WNND) is rare and accounts for less than 1%. There is insufficient information about natural history and clinical course in children, because underdiagnosis is common, and reports are scarce. On the other hand, Europe has seen a dramatic increase of WNV infections in the last decades, and the Po valley itself, in Northern Italy, has become an endemic region since 2013. CASE PRESENTATION: We hereby report a case of West-Nile virus neuroinvasive disease in a 12-year-old boy. This is one of the very few cases diagnosed in the Italian pediatric population. The clinical presentation was compatible with acute encephalitis. Diagnosis was made by detection of specific IgM in both serum and cerebrospinal fluid. He finally was discharged with complete recovery, and no neurologic sequelae after a 12-months follow up period. CONCLUSIONS: Given its non-specific clinical presentation, the diffusion of WNV constitutes a crucial and emerging concern. Even though rare, neuroinvasive WNV infection should always be suspected in pediatric patients, living or traveling in endemic areas, presenting with meningitis, encephalitis or acute flaccid paralysis during the WNV transmission season.

Original languageEnglish
Number of pages1
JournalItalian Journal of Pediatrics
Volume44
Issue number1
DOIs
Publication statusPublished - Nov 20 2018

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West Nile virus
Encephalitis
Pediatrics
Virus Diseases
Flaviviridae
RNA Viruses
Culicidae
Natural History
Meningitis
Paralysis
Nervous System
Italy
Immunoglobulin M
Cerebrospinal Fluid
Infection
Serum
Population

Keywords

  • Encephalitis
  • Flavivirus
  • Italy
  • Neuroinvasive disease
  • Pediatric
  • West Nile virus

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

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title = "West-Nile virus encephalitis in an immunocompetent pediatric patient: successful recovery",
abstract = "BACKGROUND: West Nile virus (WNV) is a mosquito-borne RNA virus belonging to the Flaviviridae family. Symptomatic infection happens in only about 20{\%} of the cases, while WNV neuroinvasive disease (WNND) is rare and accounts for less than 1{\%}. There is insufficient information about natural history and clinical course in children, because underdiagnosis is common, and reports are scarce. On the other hand, Europe has seen a dramatic increase of WNV infections in the last decades, and the Po valley itself, in Northern Italy, has become an endemic region since 2013. CASE PRESENTATION: We hereby report a case of West-Nile virus neuroinvasive disease in a 12-year-old boy. This is one of the very few cases diagnosed in the Italian pediatric population. The clinical presentation was compatible with acute encephalitis. Diagnosis was made by detection of specific IgM in both serum and cerebrospinal fluid. He finally was discharged with complete recovery, and no neurologic sequelae after a 12-months follow up period. CONCLUSIONS: Given its non-specific clinical presentation, the diffusion of WNV constitutes a crucial and emerging concern. Even though rare, neuroinvasive WNV infection should always be suspected in pediatric patients, living or traveling in endemic areas, presenting with meningitis, encephalitis or acute flaccid paralysis during the WNV transmission season.",
keywords = "Encephalitis, Flavivirus, Italy, Neuroinvasive disease, Pediatric, West Nile virus",
author = "Salvatore Savasta and Francesca Rovida and Thomas Foiadelli and Campana, {Anna Maria} and Elena Percivalle and Marseglia, {Gian Luigi} and Fausto Baldanti",
year = "2018",
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language = "English",
volume = "44",
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T1 - West-Nile virus encephalitis in an immunocompetent pediatric patient

T2 - successful recovery

AU - Savasta, Salvatore

AU - Rovida, Francesca

AU - Foiadelli, Thomas

AU - Campana, Anna Maria

AU - Percivalle, Elena

AU - Marseglia, Gian Luigi

AU - Baldanti, Fausto

PY - 2018/11/20

Y1 - 2018/11/20

N2 - BACKGROUND: West Nile virus (WNV) is a mosquito-borne RNA virus belonging to the Flaviviridae family. Symptomatic infection happens in only about 20% of the cases, while WNV neuroinvasive disease (WNND) is rare and accounts for less than 1%. There is insufficient information about natural history and clinical course in children, because underdiagnosis is common, and reports are scarce. On the other hand, Europe has seen a dramatic increase of WNV infections in the last decades, and the Po valley itself, in Northern Italy, has become an endemic region since 2013. CASE PRESENTATION: We hereby report a case of West-Nile virus neuroinvasive disease in a 12-year-old boy. This is one of the very few cases diagnosed in the Italian pediatric population. The clinical presentation was compatible with acute encephalitis. Diagnosis was made by detection of specific IgM in both serum and cerebrospinal fluid. He finally was discharged with complete recovery, and no neurologic sequelae after a 12-months follow up period. CONCLUSIONS: Given its non-specific clinical presentation, the diffusion of WNV constitutes a crucial and emerging concern. Even though rare, neuroinvasive WNV infection should always be suspected in pediatric patients, living or traveling in endemic areas, presenting with meningitis, encephalitis or acute flaccid paralysis during the WNV transmission season.

AB - BACKGROUND: West Nile virus (WNV) is a mosquito-borne RNA virus belonging to the Flaviviridae family. Symptomatic infection happens in only about 20% of the cases, while WNV neuroinvasive disease (WNND) is rare and accounts for less than 1%. There is insufficient information about natural history and clinical course in children, because underdiagnosis is common, and reports are scarce. On the other hand, Europe has seen a dramatic increase of WNV infections in the last decades, and the Po valley itself, in Northern Italy, has become an endemic region since 2013. CASE PRESENTATION: We hereby report a case of West-Nile virus neuroinvasive disease in a 12-year-old boy. This is one of the very few cases diagnosed in the Italian pediatric population. The clinical presentation was compatible with acute encephalitis. Diagnosis was made by detection of specific IgM in both serum and cerebrospinal fluid. He finally was discharged with complete recovery, and no neurologic sequelae after a 12-months follow up period. CONCLUSIONS: Given its non-specific clinical presentation, the diffusion of WNV constitutes a crucial and emerging concern. Even though rare, neuroinvasive WNV infection should always be suspected in pediatric patients, living or traveling in endemic areas, presenting with meningitis, encephalitis or acute flaccid paralysis during the WNV transmission season.

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KW - West Nile virus

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