Cauda equina arachnoiditis–a rare manifestation of West Nile virus neuroinvasive disease:A case report  

作　　者：Marija Santini Ivana Zupetic Klaudija Viskovic Juraj Krznaric Marko Kutlesa Vladimir Krajinovic Vlatka Lovrakovic Polak Vladimir Savic Irena Tabain Ljubo Barbic Maja Bogdanic Vladimir Stevanovic Anna Mrzljak Tatjana Vilibic-Cavlek 

机构地区：[1]Department for Intensive Care Medicine and Neuroinfectology,University Hospital for Infectious Diseases“Dr Fran Mihaljevic”,Zagreb 10000,Croatia [2]Department of Radiology,University Clinical Hospital Center,Clinic for Traumatology,Zagreb 10000,Croatia [3]Department of Radiology and Ultrasound,University Hospital for Infectious Diseases“Dr Fran Mihaljevic”,Zagreb 10000,Croatia [4]Department of Infectious Diseases,General County Hospital Karlovac,Karlovac 47000,Croatia [5]Department of Poultry Center,Laboratory for Virology and Serology,Croatian Veterinary Institute,Zagreb 10000,Croatia [6]Department of Virology,Croatian Institute of Public Health,Zagreb 10000,Croatia [7]Department of Microbiology and Infectious Diseases with Clinic,Faculty of Veterinary Medicine,University of Zagreb,Zagreb 10000,Croatia [8]Department of Medicine,University Hospital Merkur,Zagreb 10000,Croatia [9]School of Medicine,University of Zagreb,Zagreb 10000,Croatia

出　　处：《World Journal of Clinical Cases》2020年第17期3797-3803,共7页世界临床病例杂志

基　　金：Croatian Science Foundation,Project No. IP 2016-06-7456 CRONEUROARBO;European Union’s Horizon 2020 Research and Innovation Programme,No. 653316。

摘　　要：BACKGROUND Data regarding the neuroradiology features of the West Nile virus neuroinvasive disease(WNV NID)is rather scarce.To contribute to the knowledge of the WNV NID,we present a patient with a combination of encephalitis and acute flaccid paresis,with cauda equina arachnoiditis as the main magnetic resonance(MR)finding.CASE SUMMARY A 72-year-old female patient was admitted due to fever,headache and gait instability.During the first several days she developed somnolence,aphasia,urinary incontinence,constipation,and asymmetric lower extremities weakness.Cerebrospinal fluid analysis indicated encephalitis.Native brain computed tomography and MR were unremarkable,while spinal MR demonstrated cauda equina enhancement without cord lesions.Virology testing revealed WNV IgM and IgG antibodies in serum and cerebrospinal fluid,which confirmed acute WNV NID.The treatment was supportive.After two months only a slight improvement was noticed but cognitive impairment,loss of sphincter control and asymmetric inferior extremities weakness remained.The patient died after a month on chronic rehabilitation.CONCLUSION Cauda equina arachnoiditis is a rare,but possible neuroradiological feature in acute flaccid paresis form of WNV NID.

关 键 词：West Nile virus Central nervous system infection Cauda equina Magnetic resonance Neuroinvasive disease Case report 

分 类 号：R742[医药卫生—神经病学与精神病学]