Powassan virus encephalitis: a tertiary center experience.
Powassan virus
Tick-borne diseases
arbovirus
Journal
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
ISSN: 1537-6591
Titre abrégé: Clin Infect Dis
Pays: United States
ID NLM: 9203213
Informations de publication
Date de publication:
04 Aug 2023
04 Aug 2023
Historique:
received:
14
06
2023
revised:
25
07
2023
accepted:
01
08
2023
medline:
5
8
2023
pubmed:
5
8
2023
entrez:
4
8
2023
Statut:
aheadofprint
Résumé
Powassan virus (POWV) is an emerging arthropod-borne flavivirus, transmitted by Ixodes spp ticks, which has been associated with neuroinvasive disease and poor outcomes. A retrospective study was conducted at Mayo Clinic from 2013 to 2022. We included clinical and epidemiological data of probable and confirmed neuroinvasive POWV cases. Sixteen patients with neuroinvasive POWV were identified with a median age of 63.2 years and 62.5% were male. Six patients presented with rhombencephalitis, four with isolated meningitis, three with meningoencephalitis, two with meningoencephalomyelitis, and one with opsoclonus myoclonus syndrome. A median time of 18 days was observed between symptom onset and diagnosis. Cerebrospinal fluid analysis showed lymphocytic pleocytosis with elevated protein and normal glucose in the majority of patients. Mortality within 90 days occurred in three cases (18.8%), and residual neurological deficits were seen in eight (72.7%) survivors. To our knowledge, this is the largest case series of patients with neuroinvasive POWV infection. We highlight the importance of a high clinical suspicion among patients that live in or travel to high-risk areas during the spring to fall months. Our data show high morbidity and mortality among patients with neuroinvasive disease.
Sections du résumé
BACKGROUND
BACKGROUND
Powassan virus (POWV) is an emerging arthropod-borne flavivirus, transmitted by Ixodes spp ticks, which has been associated with neuroinvasive disease and poor outcomes.
METHODS
METHODS
A retrospective study was conducted at Mayo Clinic from 2013 to 2022. We included clinical and epidemiological data of probable and confirmed neuroinvasive POWV cases.
RESULTS
RESULTS
Sixteen patients with neuroinvasive POWV were identified with a median age of 63.2 years and 62.5% were male. Six patients presented with rhombencephalitis, four with isolated meningitis, three with meningoencephalitis, two with meningoencephalomyelitis, and one with opsoclonus myoclonus syndrome. A median time of 18 days was observed between symptom onset and diagnosis. Cerebrospinal fluid analysis showed lymphocytic pleocytosis with elevated protein and normal glucose in the majority of patients. Mortality within 90 days occurred in three cases (18.8%), and residual neurological deficits were seen in eight (72.7%) survivors.
CONCLUSIONS
CONCLUSIONS
To our knowledge, this is the largest case series of patients with neuroinvasive POWV infection. We highlight the importance of a high clinical suspicion among patients that live in or travel to high-risk areas during the spring to fall months. Our data show high morbidity and mortality among patients with neuroinvasive disease.
Identifiants
pubmed: 37540989
pii: 7237411
doi: 10.1093/cid/ciad454
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© The Author(s) 2023. Published by Oxford University Press on behalf of Infectious Diseases Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.