Earlier this week, we gave you a hypothetical patient with the following case:
This week's hypothetical patient is an 8-year-old boy from a small, farming community in west Texas. He was admitted to the hospital in July with a fever, neck stiffness, muscle weakness, numbness, and intermittent tremors. He also reported having a headache and did not seem to know where he was upon examination. His parents are concerned that he could be experiencing complications from kidney issues that he had been treated for over a year ago. They stated that he had been playing outside a lot as it had been warm and sunny for the past several weeks. They remarked that he really enjoys fishing at the small pond on their property, despite the fact that he frequently comes home with mosquito bites. The physician ordered an blood test, which demonstrated an elevated immune response. The physician then ordered an MRI and a lumbar puncture. The results of these tests confirmed the physician's suspicions. The physician orders that the boy be put on intravenous fluids as supportive therapy and prescribes pain medication. She then discusses the boy's treatment options with his parents. There is no definitive cure for his condition, but there is emerging research showing positive results using interferon therapy or they can try to use IGIV or MGAWN1 therapies. There is also the possibility that with the currently administered supportive treatment, the boy's immune system could overcome his illness on its own. In the meantime, the boy is being monitored while the physician and the boy's parents weigh these options.
This week's hypothetical patient is an 8-year-old boy from a small, farming community in west Texas. He was admitted to the hospital in July with a fever, neck stiffness, muscle weakness, numbness, and intermittent tremors. He also reported having a headache and did not seem to know where he was upon examination. His parents are concerned that he could be experiencing complications from kidney issues that he had been treated for over a year ago. They stated that he had been playing outside a lot as it had been warm and sunny for the past several weeks. They remarked that he really enjoys fishing at the small pond on their property, despite the fact that he frequently comes home with mosquito bites. The physician ordered an blood test, which demonstrated an elevated immune response. The physician then ordered an MRI and a lumbar puncture. The results of these tests confirmed the physician's suspicions. The physician orders that the boy be put on intravenous fluids as supportive therapy and prescribes pain medication. She then discusses the boy's treatment options with his parents. There is no definitive cure for his condition, but there is emerging research showing positive results using interferon therapy or they can try to use IGIV or MGAWN1 therapies. There is also the possibility that with the currently administered supportive treatment, the boy's immune system could overcome his illness on its own. In the meantime, the boy is being monitored while the physician and the boy's parents weigh these options.Today, we reveal that our hypothetical patient was diagnosed as having:
West Nile Virus
West Nile Virus (WNV) is a common virus transferred by mosquitoes in the United States. The virus is sustained in reservoir populations of birds and transmitted to people via a bite from an infected mosquito. About 70-80% of people who are infected with WNV never develop symptoms; however, severe cases can be life-threatening, especially for patients over 60 years of age and/or people with medical conditions that impair the immune system, such as cancer or kidney disease. People with diabetes or hypertension are also at an increased risk for WNV. In severe cases, symptoms manifest within 3-14 days post-infection and may include fever, confusion, convulsions, muscle weakness, loss of vision, numbness, paralysis, or even coma. If not treated, the infection can cause permanent brain damage, but most people make it to a hospital for treatment before WNV progresses to that point. WNV can be diagnosed with a blood test, but severe cases often necessitate a lumbar puncture and sometimes an MRI to see how far the infection has progressed and to determine the most appropriate supportive treatments. Interferon therapy is a promising new treatment for WNV that uses substances produced by the immune system to treat encephalitis, but the research is not yet conclusive. There is currently a WNV vaccine for horses, but there has not been an effective human vaccine developed yet.
Thanks for joining us for this week's Mystery Case and we hope to see you next week!
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