Fatal West Nile Virus Encephalitis in a Heart Transplant Recipient

Adam J Gomez; Jesse J Waggoner; Megumi Itoh; Seth A Hollander; Kathleen M Gutierrez; Indre Budvytiene; Niaz Banaei; Benjamin A Pinsky

doi:10.1128/JCM.00834-15

Fatal West Nile Virus Encephalitis in a Heart Transplant Recipient

J Clin Microbiol. 2015 Aug;53(8):2749-52. doi: 10.1128/JCM.00834-15. Epub 2015 May 20.

Authors

Adam J Gomez¹, Jesse J Waggoner², Megumi Itoh³, Seth A Hollander⁴, Kathleen M Gutierrez³, Indre Budvytiene⁵, Niaz Banaei⁶, Benjamin A Pinsky⁷

Affiliations

¹ Department of Pathology, Stanford University School of Medicine, Stanford, California, USA.
² Department of Medicine, Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, California, USA.
³ Department of Pediatrics, Division of Pediatric Infectious Diseases, Stanford University School of Medicine, Stanford, California, USA.
⁴ Department of Pediatrics, Division of Cardiology, Stanford University School of Medicine, Stanford, California, USA.
⁵ Clinical Microbiology Laboratory, Stanford Health Care and Stanford Children's Health, Stanford, California, USA.
⁶ Department of Pathology, Stanford University School of Medicine, Stanford, California, USA Department of Medicine, Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, California, USA Clinical Microbiology Laboratory, Stanford Health Care and Stanford Children's Health, Stanford, California, USA.
⁷ Department of Pathology, Stanford University School of Medicine, Stanford, California, USA Department of Medicine, Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, California, USA bpinsky@stanford.edu.

Abstract

The diagnosis of encephalitis is particularly challenging in immunocompromised patients. We report here a case of fatal West Nile virus encephalitis confounded by the presence of budding yeast in the cerebrospinal fluid (CSF) from a patient who had undergone heart transplantation for dilated cardiomyopathy 11 months prior to presentation of neurologic symptoms.

Publication types

Case Reports

MeSH terms

Central Nervous System Fungal Infections / complications
Central Nervous System Fungal Infections / diagnosis*
Central Nervous System Fungal Infections / pathology
Cerebrospinal Fluid / cytology
Cerebrospinal Fluid / virology
Coinfection / complications
Coinfection / diagnosis*
Coinfection / pathology
Fatal Outcome
Heart Transplantation / adverse effects*
Humans
Immunocompromised Host
Male
Microscopy
Saccharomycetales / isolation & purification
Transplant Recipients*
West Nile Fever / complications
West Nile Fever / diagnosis*
West Nile Fever / pathology
West Nile virus / isolation & purification
Young Adult