CD4 count <200mm 3 with TB
Not reported
Died 18 days after admission Improved rapidly and discharged after 3 days
Conference summary
Rimland et al.
M
2003
Not reported
50
JOURNAL OF THE LOUISIANA STATE MEDICAL SOCIETY
CD4 count <200 cells/µL
Not reported
Fever, headache, confusion, feeling ‘slow’
Conference summary
Rimland et al.
M
2003
48
2005 YEAR
Michigan LOCATION
Confusion PRESENTING SYMPTOMS
AGE SEX LABS
OUTCOME
Case report STUDY TYPE
Gyure AUTHOR
M
Not reported
Died after 2 months
69
Discharged although with right peripheral seventh cranial nerve palsy Discharged although with right peripheral sevent cranial nerve palsy Not reported Discharged to facility for chronic vent patient but died two months later harged after five days, with r solution of symptoms
Weakness, headache, and myalgia Headache, fever, neck stiffness, p otophobia, vomiting
Unzek et al. Szilak and Minamoto
CD4 count 128 cells/µL +CSF WNVlgM CD4 count 351 mm 3 +CSF WNV lgM
Case report Case report
2006 2000
Ohio Bronx, NY
38 F
M
45
Case report Case series WNV encephalomyelitis and correlates these findings with a variety of clinical features, including illness duration and underlying medical condition. s ries WNV encephalomyelitis and correlates these findings with a variety of clinical features, including illness duration and underlying medical condition. Case report Case report
Weakness of the right upper extremity, headache, neck pain, fever, and malaise Fever, extremity weakness, nausea and vomiting Mental status changes, fever, chills, headaches with neck pain, and photophobia Not reported Not reported
CD4 count 324 cells/µL +CSF WNVlgM AIDS
California Not reported
Torno et al. Guarner et al.
M
2006 2002
47 51
M
Jamison et al.
2007
Virginia
41
CD4 count 93mm 3
Not reported
Guarner et al.
Not reported
M
AIDS
2002
63
CD4 count 10/mm 3 +CSF PCR for WNV
M
Josekutty et al.
2013
NYC
Not reported
44
Died 18 days after admission Improved rapidly and discharged after 3 days
CD4 count <200mm 3 with TB
Not reported
Conference summary
Rimland et al.
M
2003
Not reported
50
Table 1: WNV neuro-invasive disease in HIV-positive patients
CD4 count <200 cells/µL
2003 2005 mised population, the risk for severe CNS infection is increased. Neurologic illnesses can occur in 40-60% of HIV-infected people, and opportunistic infections occurring only during late stage in- fection when the CD4 count falls below 200 cells/dL 2 . 2006 In Louisiana the number of newborns delivered to mothers with HIV infection in 2013was 160with all ine Louisiana Department of Health districts represented. Of the 44 mothers with HIV in the Baton Rouge region in 2013, 24 were delivered at Woman’s Hospital. Based on hospital records, this number has increased in recent years (Table 2). 15 2013 Of concern in the pregnant population is the risk of intrauterine transmission of WNV. The first suspected case occurred in 2002 and involved an infant who appeared grossly normal at birth but had bilateral chorioretinitis and severe cystic destruction of temporal and occipital cerebral tissue. In the same year, four additional WNV infections during pregnancy were reported. Three infections result d in no fet l infection or adverse outcomes for the infants; in one instance, the otherwise normal premature infant was not tested for WNV infection. Since these findings, numerous studies including a long term follow-up study using the CDCWNV national registry found that prenatal exposure to WNV infection does not commonly result in congenital WNV infection, serious adverse birth outcomes, or developmental delay. 5 Similarly, no abnormal findings were noted in the newborn in our case. 2007 Virginia NYC Mental status changes, fever, chills, headaches with neck pain, and photophobia 41 44 Jamison et al. Josekutty et al. Public health programs and personal protection strategies have emerged as the best resources in combating the emergence of arbovirus infections in endemic areas. Use of Environmental Protection Agency (EPA) approved mosquito repellent such as DEET (N, N-diethyl-mtoluamide), wearing clothing that covers 2006 Michigan Ohio California Fever, headache, confusion, feeling ‘slow’ Confusion Weakness, headache, and myalgia Weakness of the right upper extremity, headache, neck pain, fever, and malaise Fever, extremity weakness, nausea and vomiting 48 69 45 47 Rimland et al. Gyure Unzek et al. Torno et al. Not reported
Conference summary
M
Not reported all skin surfaces and participation in local mosquito control programs are practices that all physicians can encourage in their patient population. 6 ata by both t e EPA and CDC endorse the safety of DEET in pregnant women. 16 This is another example of preventive medicine that those charged with the management of an obstetrical patient population must consider when providing optimal care. CD4 count 128 cells/µL +CSF WNVlgM Case report Case report Died after 2 months
M
Discharged although with right peripheral seventh cranial nerve palsy Discharged although with right peripheral sevent cranial nerve palsy Discharged to facility for chronic vent patient but died two months later 24
M
CD4 count 324 cells/µL +CSF WNVlgM
Table 2
Case report
M
WOMAN’S HOSPITAL TOTAL NUMBER OF DELIVERIES TO MOTHERS WITH HIV 2013
Case report
M
CD4 count 93mm 3
2014
46
CD4 count 10/mm 3 +CSF PCR for WNV 2015 2016 (thru 10/31/16)
Case report
M
Not reported
35
30
Table 2. Woman’s Hospital total number of deliveries to mothers with HIV
160 J La State Med Soc VOL 169 NOVEMBER/DECEMBER 2017
Made with FlippingBook Digital Publishing Software