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Table 3 Main clinical, laboratory and instrumental findings regarding the three cases here described

From: Three case reports of West Nile virus neuroinvasive disease: lessons from real-life clinical practice

  Symptoms Neurological exam CSF finding MRI findings EEG findings Management Outcome
Patient#1
68 yo
Male
Caucasian
Fever, confusion, skin rash Diplopia, bilateral positive Babinski sign, resistance to head passive mobilization Mononuclear pleocytosis, hyper-protidorrachia, hypo-glycorrachia No abnormalities reported Bilateral slow-wave activity on central-anterior leads Supportive care; suspension of empiric ABT on diagnosis confirmation Mild cognitive impairment followed by complete recovery; no relapses reported
Patient#2
66 yo
Male
Caucasian
Headache, cervical pain, nausea, low-grade fever Slight right upper limb weakness Mononuclear pleocytosis, slightly increased proteins, hypo-glycorrachia No abnormalities reported Minimal bilateral slow-wave activity on temporal leads Supportive care; suspension of empiric ABT on diagnosis confirmation Mild cognitive impairment followed by complete recovery; no relapses reported
Patient#3
85 yo
Female
Caucasian
Fever, dysuria, skin rash, disorientation Nuchal rigidity, diffuse tremors, slurred speech, impaired task execution, focal vision defect Increased RBC count, polymorphonuclear pleocytosis, hyper-protidorrachia, hypo-glycorrachia Lobar white matter hyperintensities on T2-weighted sequences bilateral slow-wave alterations were recorded on central-anterior leads Supportive care; suspension of empiric ABT on diagnosis confirmation; antiepileptic therapy Significant motor/cognitive impairment followed by gradual recovery; no relapses reported
  1. ABT antibiotic therapy; RBC red blood cell