West Nile Virus Infection
Imad T. Zak1,2,
Deniz Altinok1,
Joseph R. Merline3,
Subhash Chander1 and
Karl K. Kish1
1 Department of Radiology, Wayne State University, Detroit, MI.
2 Department of Radiology, Harper University Hospital, 3390 John R, Detroit, MI
48201.
3 Department of Pathology, Wayne State University, Detroit, MI.
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Fig. 1. —Schematic shows life cycle of West Nile virus.
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Fig. 2. —53-year-old man with history of fever and confusion. Axial
T2-weighted FLAIR image of brain shows multiple variable-sized nonspecific
discrete foci of T2 signal abnormality in periventricular white matter, basal
ganglia, and left insula.
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Fig. 3. —72-year-old man who presented with mental status change. Axial
T2-weighted FLAIR image of brain shows focal signal abnormality in left
thalamus.
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Fig. 4. —55-year-old woman with right-sided weakness and neck pain. Axial
T2-weighted FLAIR image of brain shows symmetric signal abnormality in
thalami.
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Fig. 5. —44-year-old woman who presented to emergency department unresponsive
with preceding 2-day history of severe headache (same patient in Figs.
9A and
9B). Axial T2-weighted FLAIR
image of brain shows signal abnormality in medial left temporal lobe. Patient
had seizures and was proven to have West Nile virus encephalitis.
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Fig. 6. —41-year-old man with history of paraparesis. Sagittal spin-echo
T2-weighted image of cervical spine shows localized swelling and T2 signal
abnormality of spinal cord.
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Fig. 7A. —45-year-old woman with trouble walking because of left leg weakness
preceded by localized backache and fever. Unenhanced sagittal T1-weighted
image of lumbar spine shows clumping and thickening of cauda equina.
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Fig. 7B. —45-year-old woman with trouble walking because of left leg weakness
preceded by localized backache and fever. Gadolinium-enhanced sagittal
T1-weighted image of spine shows enhancement in anterior aspect of conus
medullaris and cauda equina.
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Fig. 8A. —38-year-old man with AIDS previously controlled on medication who
presented with mental status changes and encephalopathy. Axial T2-weighted
FLAIR image of brain shows symmetric T2 signal abnormality in cerebral
peduncles.
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Fig. 8B. —38-year-old man with AIDS previously controlled on medication who
presented with mental status changes and encephalopathy. Axial T2-weighted
FLAIR image from a 4-week follow-up brain MRI study shows interval development
of symmetric T2 signal abnormalities in dentate nuclei.
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Fig. 9A. —44-year-old woman who presented to emergency department unresponsive
with preceding 2-day history of severe headache (same patient in
Fig. 5). Axial T2-weighted
image shows subtle T2 signal abnormality in medial left temporal lobe.
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Fig. 9B. —44-year-old woman who presented to emergency department unresponsive
with preceding 2-day history of severe headache (same patient in
Fig. 5). Diffusion-weighted
image shows intense signal abnormality in medial left temporal lobe.
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Copyright © 2005 by the American Roentgen Ray Society.
