Which physical findings are characteristic of West Nile virus (WNV) infection and encephalitis (WNE)?

Updated: Apr 05, 2021
  • Author: David J Cennimo, MD, FAAP, FACP, AAHIVS; Chief Editor: Michael Stuart Bronze, MD  more...
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Most patients with symptomatic WNV infection are febrile.

Neurological examination findings may vary depending on the severity and manifestations of the disease. The presence of Kernig or Brudzinski signs may indicate meningeal irritation in patients with meningitis. Tremor, either fine or coarse, may be encountered. Mental status is likely to be depressed in patients with encephalitis and can manifest as subtle increased sleepiness to frank coma. Confusion or neurocognitive signs may be present. Acute flaccid paralysis results in a poliomyelitis-like loss of tone and strength and may affect one or more extremities.

Examination findings may be remarkable for diffuse maculopapular rash.

Ocular findings may include chorioretinitis featuring “target-like” lesions, retinal hemorrhages, and vitreitis. [25, 26, 27]

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