A Cluster Study of Predictors of Severe West Nile Virus Infection
| Autor: | Foued Ben Romdhane, Henda Triki, Mondher Letaief, Noureddine Bouzouiaia, Lamia Ouanes-Besbes, Fekri Abroug, Moncef Khairallah |
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| Přispěvatelé: | CHU Fattouma Bourguiba [Monastir] (HFB), Laboratoire de Virologie Clinique, Référence Régional OMS pour la Poliomyélite et la Rougeole - Laboratory of Clinical Virology, WHO Regional Reference Laboratory on Poliomyelitis and Measles, Institut Pasteur de Tunis, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP)-Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO) |
| Rok vydání: | 2006 |
| Předmět: |
Male
animal diseases viruses Eye Infections Viral Antibodies Viral Severity of Illness Index Disease Outbreaks MESH: Aged 80 and over 0302 clinical medicine MESH: West Nile Fever/virology Cluster Analysis Prospective Studies 030212 general & internal medicine Prospective cohort study Aged 80 and over MESH: Aged MESH: Middle Aged biology MESH: Chorioretinitis/virology MESH: Enzyme-Linked Immunosorbent Assay virus diseases Meningoencephalitis CI MESH: Chorioretinitis/diagnosis General Medicine Middle Aged MESH: West Nile Fever/diagnosis 3. Good health Flavivirus [SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology Female MESH: Eye Infections Viral/virology MESH: Tunisia West Nile virus Meningitis Encephalitis Adult medicine.medical_specialty Tunisia MESH: West Nile virus/immunology Enzyme-Linked Immunosorbent Assay CSF cerebrospinal fluid 03 medical and health sciences Flaviviridae WNV MESH: Severity of Illness Index MESH: West Nile Fever/epidemiology Internal medicine medicine Humans Aged MESH: Disease Outbreaks MESH: Eye Infections Viral/diagnosis MESH: Humans business.industry Chorioretinitis MESH: Adult Eye infection medicine.disease biology.organism_classification MESH: Cluster Analysis MESH: Eye Infections Viral/epidemiology MESH: Male MESH: Prospective Studies nervous system diseases confidence interval Immunology MESH: Antibodies Viral/immunology 030221 ophthalmology & optometry MESH: Chorioretinitis/epidemiology business MESH: Female West Nile Fever |
| Zdroj: | Mayo Clinic Proceedings Mayo Clinic Proceedings, Elsevier, 2006, 81 (1), pp.12-16. ⟨10.4065/81.1.12⟩ |
| ISSN: | 0025-6196 |
| DOI: | 10.4065/81.1.12 |
| Popis: | International audience; OBJECTIVE: To assess the value of multifocal chorioretinitis and of clinical manifestations and biologic parameters in the diagnosis of West Nile virus (WNV) infection.PATIENTS AND METHODS: We conducted a prospective, controlled case series study during an outbreak of WNV infection between August 15 and October 24, 2003, of 64 consecutive patients who presented with clinical manifestations consistent with WNV disease. In each patient, standardized clinical and biologic data were collected. An ophthalmologic examination searching particularly for multifocal chorioretinitis was performed.RESULTS: Of 64 patients who presented primarily with meningitis and/or encephalitis, 36 had IgM antibodies against WNV. The WNV-infected patients tended to be older (median age of 54 years vs 46 years in WNV infection and control groups, respectively) and more frequently had diabetes (30% vs 7% in WNV infection and control groups, respectively; P = .03). Multifocal chorioretinitis was found in 75% of WNV-infected patients but in no patient in the control group (P = .001). Blood glucose and amylase levels were higher in WNV-infected patients, whereas serum sodium levels were lower. The cerebrospinal fluid leukocyte count and protein levels were significantly higher in WNV meningitis or encephalitis. Overall, multifocal chorioretinitis had 100% specificity and 73% sensitivity (88% when only patients with meningitis or encephalitis were analyzed) for the diagnosis of WNV. Multivariate analysis disclosed multifocal chorioretinitis as the only predictor of WNV infection (odds ratio, 62; 95% confidence interval, 6-700; P = .001).CONCLUSION: Multifocal chorioretinitis appears to be a specific marker of WNV infection, particularly in patients who present with meningoencephalitis. An ophthalmologic examination should be part of the routine evaluation of such patients. |
| Databáze: | OpenAIRE |
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