West Nile Encephalitis in 2 Hematopoietic Stem Cell Transplant Recipients: Case Series and Literature Review

Abstract

Most human cases of West Nile virus infection are acquired via bites from an infected mosquito. In some cases, infection may also be transmitted by infected blood products or transplanted organs. There have been recent publications suggesting that chemotherapy and immunosuppression may increase a person's risks of developing central nervous system disease if the person is infected with the West Nile virus. Because patients undergoing hematopoietic stem cell transplantation not only are immunocompromised, but also receive multiple blood products, they are at a particularly high risk for acquiring symptomatic disease if exposed to the West Nile Virus. We describe here 2 patients who underwent hematopoietic transplantation at our institution and subsequently developed fatal West Nile virus infections.

West Nile Virus--Associated Encephalitis in Recipients of Renal and Pancreas Transplants: Case Series and Literature Review

“…In addition, immunocompromised patients P p .08 may have prolonged viremia, delayed development of antibody, and an increased likelihood of severe disease [14]. The aggressive nature of the illness in immunocompromised patients is further illustrated by the recent report of mortality in 2 stem cell transplant recipients due to West Nile encephalitis [15].…”

Implicating the Need for Serological Testing of Borna Disease Virus and Dengue Virus During Blood Transfusion

“…Other mosquito-borne flavivirus, such as West Nile virus, is transmitted efficiently in breast milk, blood transfusion, organ transplantation, stem cell transplantation, intra-uterine exposure and needle stick injuries (Hong et al, 2003;Iwamoto et al, 2003). The main transmission route for DENV is by vector mosquito.…”

West Nile virus infection in bone marrow transplant patients

“…To date, there have been four other case reports of WNV encephalitis in BMT patients, all of whom, similar to our three patients, presented with fever without meningismus or rash. [4][5][6] Interestingly, both Reddy et al and Hong et al described focal neurologic deficits in two patients who presented with fever and asymmetric upper extremity weakness. Hong et al also described febrile seizures in one of his patients, which are considered an unusual presentation for WNV encephalitis.…”