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Introduction: Limited evidence suggests that focal neurological injury (e.g., acute flaccid paralysis) caused by infection with the West Nile virus (WNV) is more common in older patients. We re- evaluate this association in a series of patients who were infected with the WNV during the 2002 epidemic. Methods: We pe rformed a retrospective chart review of 34 patients who were hospitalized for tr eatment of serologically confirmed WNV infection. Measurements included the pati ent’ s demographic characteristics, baseline medical diagnoses, the occurrence of symptoms and exam findings, the results of various diagnostic tests, and the patient’ s clinical outcome. Results: Patients infected with the WNV who develo ped focal neurological injury were found to be comparable to patients who did no t develop focal neurological injury both in terms of patient age and the number of medical conditions the patient had prior to infection. This is in contrast to WNV- infected patients who developed an encephalitis- like clinical course, o r who died or were institutionalized after their hospitalization; such patients tended to be older and- in cases with a poor outcome- have more medical condit ions prior to WNV infection. Conclusions: In our patient group, focal neurologic al injury caused by WNV infection was not related to advanced patient age or to the number of medical conditions the patient had prior to infection. Our finding s bring into question commonly held views about the development of focal neurolo gical injury caused by WNV infection, and they raise concerns about the manageme nt of future WNV epidemics and the testing and use of potential antiviral treatm ents against this infection.
Introduction: Limited evidence suggests that focal neurological injury (eg, acute flaccid paralysis) caused by infection with the West Nile virus (WNV) is more common in older patients. We re- evaluate this association in a series of patients who were infected with the WNV during the 2002 epidemic. Methods: We pe rformed a retrospective chart review of 34 patients who were hospitalized for tr eatment of serologically confirmed WNV infection. Measurements included the pati ent ’s demographic characteristics, baseline medical diagnoses, the occurrence of symptoms and exams findings, the results of various diagnostic tests, and the patient’s clinical outcome. Results: Patients infected with the WNV who develo ped focal neurological injury were found to be comparable to patients who did no t develop focal neurological injury both in terms of patient age and the number of medical conditions the patient had prior to infection. This is in contrast to WNV- infected patients who developed an encephalitis-like clinical course, or who died or were institutionalized after their hospitalization; such patients tended to be older and- in cases with a poor outcome- have more medical condit ions prior to WNV infection. Conclusions: In our patient group, focal neurologic al injury caused by WNV infection was not related to advanced patient age or to the number of medical conditions the patient had prior to infection. Our finding s bring into question generally held views about the development of focal neurolo gical injury caused by WNV infection, and they raise concerns about the manageme nt of future WNV epidemics and the testing and use of potential antiviral treats against this infection.