 | WEST NILE VIRUS: DETECTION, SURVEILLANCE, AND CONTROL
Copyright © 2001 by the New York Academy of Sciences
description
Annals of the New York Academy of Sciences 951:172-178 (2001)
© 2001 New York Academy of Sciences
West Nile Encephalitis
The Neuropathology of Four Fatalities
BARBARA A. SAMPSON AND
VERNON ARMBRUSTMACHER
Office of Chief Medical Examiner of the City of New York, 520 First Avenue, New York, New York 10016, USA
Address for correspondence: Barbara A. Sampson, M.D., Ph.D., Office of Chief Medical Examiner of the City of New York, 520 First Ave., New York, NY 10016. Voice: 212-447-2335; fax: 212-447-2716.
basampson{at}yahoo.com
West Nile virus was identified by immunohistochemistry (IHC) and polymerase chain reaction (PCR) as the etiologic agent in four encephalitis fatalities in New York City in the late summer of 1999. Fever and profound muscle weakness were the predominant symptoms. Autopsy disclosed encephalitis in two instances and meningoencephalitis in the remaining two. The inflammation was mostly mononuclear and formed microglial nodules and perivascular clusters in the white and gray matter. The brain stem, particularly the medulla, was involved most extensively. In two brains, cranial nerve roots had endoneural mononuclear inflammtion. In addition, one person had acute pancreatitis. On the basis of our experience, we offer recommendations for the autopsy evaluation of suspected WNV fatalities.
Key Words: West Nile virus • encephalitis • pathology • autopsy
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