Journal Highlight: Concurrent West Nile Virus infection in pneumococcal meningitis: Clinical and MRI features

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  • Published: Apr 20, 2015
  • Author: spectroscopyNOW
  • Channels: MRI Spectroscopy
thumbnail image: Journal Highlight: Concurrent West Nile Virus infection in pneumococcal meningitis: Clinical and MRI features
The clinical and neuroimaging findings are reported for an immunocompetent patient with concurrent pneumococcal and West Nile virus meningoencephalitis with relapsing clinical course despite a full course of antibiotic treatment.

Concurrent West Nile Virus infection in pneumococcal meningitis: Clinical and MRI features

Journal of Neuroimaging, 2015, 25, 312-315
Gabriella Szatmary and A. Arturo Leis

Abstract: We report the clinical and neuroimaging findings of an immunocompetent patient with concurrent pneumococcal and West Nile virus meningoencephalitis with relapsing clinical course despite a full course of antibiotic treatment. The patient developed acute oculomotor nerve palsy with pupillary involvement and bilateral hearing loss, and delayed right leg monoparesis. We speculate that coexisting bacterial and viral neuroinvasive infections contributed to the unusual clinical and imaging manifestations, and that overwhelming laboratory and clinical features of bacterial meningitis masked the typical features of CNS viral infection. Therefore, atypical presentations of bacterial meningitis should raise a high index of suspicion for coexisting infections, even in immunocompetent patients, and evolving neuroimaging findings may be helpful in substantiating clinical suspicion and guiding further management.

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