West Nile Virus infection in a renal transplant recipient resulting in polioencephalomylelitis, quadriplegia, and global brain atrophy

Kadkhoda, Kamran; Embil, John M.; McKibbin, Lundy R.; McEachern, James; Drebot, Michael A.

doi:10.1016/j.idcr.2019.e00551

Cited by 4 publications

(9 citation statements)

References 10 publications

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Section: Discussionmentioning

confidence: 99%

“…Most transplant recipients with WNv infections have been on MMF, calcineurin inhibitor and steroids regimen, that has an impact on both, B and T cells. 9 , 10 , 11 , 14 , 16 , 18 , 22 , 23 , 26 …”

Section: Discussionmentioning

confidence: 99%

“…The initial clinical presentation can be nonspecific; therefore a high index of suspicion for WNv infections should be present during high mosquito activity period and in SOT recipients with fever and CNS (central nervous system) manifestations. The most common presentation for WNv infection is fever, followed by neurological manifestation (abnormal movements, weakness, mental status alteration) and gastrointestinal symptoms (nausea, vomiting, diarrhea, abdominal pain) 9–11,14–26 …”

Section: Discussionmentioning

confidence: 99%

“…The most common presentation for WNv infection is fever, followed by neurological manifestation (abnormal movements, weakness, mental status alteration) and gastrointestinal symptoms (nausea, vomiting, diarrhea, abdominal pain). [9][10][11][14][15][16][17][18][19][20][21][22][23][24][25][26] Neuroinvasive WNv infections, although diagnosed in a minority of patients, can lead to long-term neurologic, neuropsychologic and cognitive impairment and is associated with increased mortality 1 and isolated acute flaccid paralysis. 27 Older age (>60 years), male gender, diabetes, hypertension, chronic renal disease, history of cancer, and alcohol abuse are risk factors for severe disease and encephalitis, while hypertension was a risk factors for meningitis.…”

Section: Discussionmentioning

confidence: 99%

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Neuroinvasive West Nile virus infections after solid organ transplantation: Single center experience and systematic review

Abbas

Qiu

Sikyta

et al. 2022

Transplant Infectious Dis

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West Nile virus (WNv) is a major cause of viral encephalitis in the United States. WNv infection is usually asymptomatic or a limited febrile illness in the immunocompetent hosts, although a small percentage can develop neuroinvasive disease. Neuroinvasive disease due to WNv in solid organ transplant recipients occurs at higher rates than observed in the general population and can have long term neurological sequalae. Methods We retrospectively reviewed medical records of all solid organ transplant recipients at our institution who tested positive for WNv from 2010 to 2018. Two reviewers performed electronic searches of Medline, Embase, Cochrane Library of literature of WNv infections in SOT. Descriptive statistics were performed on key variables. Results Eight recipients (mean age 54, five males) were diagnosed with neuroinvasive WNv infection at our institution. Distribution of infection was as follows: five kidney transplants, one in each kidney‐pancreas, liver, and lung. Diagnoses included meningitis (3), encephalitis (1), meningo‐encephalitis (4). Median time from transplant to infection was 49.8 months (2.7–175.4). No infections were considered donor‐derived. Five patients received treatment with IVIG. Six patients were alive at median follow‐up of 49.5 months (21.7–116.8). We identified 29 studies published from 2002 to 2019. Median time from transplant to infection was 14.2 months, with similar allograft distribution; 53% were donor‐derived infections. Conclusion WNv infections in solid organ transplant recipients can be a consequence of organ donation or can be acquired via the community. Infections can be more severe in SOT recipients and lead to neuroinvasive disease.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Neuroinvasive West Nile virus infections after solid organ transplantation: Single center experience and systematic review

Abbas

Qiu

Sikyta

et al. 2022

Transplant Infectious Dis

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“…It has been shown that the virus might be present and viable in solid organs despite negative serology results. Thus, solid organ transplants pose a potential risk to recipients [ 44 , 173 , 182 , 183 , 185 , 186 , 187 , 188 , 189 ].…”

Section: Wnv Ecologymentioning

confidence: 99%

West Nile Virus: An Update on Pathobiology, Epidemiology, Diagnostics, Control and “One Health” Implications

et al. 2020

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West Nile virus (WNV) is an important zoonotic flavivirus responsible for mild fever to severe, lethal neuroinvasive disease in humans, horses, birds, and other wildlife species. Since its discovery, WNV has caused multiple human and animal disease outbreaks in all continents, except Antarctica. Infections are associated with economic losses, mainly due to the cost of treatment of infected patients, control programmes, and loss of animals and animal products. The pathogenesis of WNV has been extensively investigated in natural hosts as well as in several animal models, including rodents, lagomorphs, birds, and reptiles. However, most of the proposed pathogenesis hypotheses remain contentious, and much remains to be elucidated. At the same time, the unavailability of specific antiviral treatment or effective and safe vaccines contribute to the perpetuation of the disease and regular occurrence of outbreaks in both endemic and non-endemic areas. Moreover, globalisation and climate change are also important drivers of the emergence and re-emergence of the virus and disease. Here, we give an update of the pathobiology, epidemiology, diagnostics, control, and “One Health” implications of WNV infection and disease.

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Mycophenolate-mofetil/prednisone/tacrolimus

2019

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West Nile Virus infection in a renal transplant recipient resulting in polioencephalomylelitis, quadriplegia, and global brain atrophy

Cited by 4 publications

References 10 publications

Neuroinvasive West Nile virus infections after solid organ transplantation: Single center experience and systematic review

Neuroinvasive West Nile virus infections after solid organ transplantation: Single center experience and systematic review

West Nile Virus: An Update on Pathobiology, Epidemiology, Diagnostics, Control and “One Health” Implications

Mycophenolate-mofetil/prednisone/tacrolimus

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