Abstract

Background: West Nile virus (WNV) is now endemic in Europe and continues to spread to several countries, with strains 1 and 2 primarily responsible for outbreaks. According to the European Centre for Disease Prevention and Control (ECDC), Italy accounts for the majority of locally acquired cases and West Nile neuroinvasive disease (WNND).
Case report: We present the first case described in Italy and Europe of WNND-related Guillain-Barré syndrome (GBS). Phylogenetic analysis showed that the genome belonged to the WNV-2, sublineage 2a, clustering within sequences from genomes originating mainly from Hungarian 578/10 strain, a particularly virulent strain.
Conclusion: The first case of GBS as a presentation of WNND in a European patient is reported, along with a review of all previously published cases of GBS related to WNND. The United States Centers for Diseases Control and Prevention (CDC) documented 13% of WNV infections manifest as GBS, with a gradual and slow improvement, often with residual neurologic deficits of varying severity. Physicians should be aware that the presentation of a patient to an emergency department with GBS, during a certain epidemiological period of the year, should raise the clinical suspicion that the GBS may be related to a WNND.

*Dr. Sonia Greco and Dr. Concetta Castilletti contributed equally to this work as last co-author.

Author Details

Authors

• Antonio Mastroianni¹
• Sonia Greco¹*
• Concetta Castilletti²*

Departments

• ¹ Infectious and Tropical Diseases Unit, Azienda Ospedaliera di Cosenza, “Annunziata” Hub Hospital, Cosenza, and
• ² Virology and Emerging Pathogens Unit, Department of Infectious - Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Verona, Italy

Address

Dr. Antonio Mastroianni
Infectious & Tropical Diseases Unit
Azienda Ospedaliera di Cosenza
Viale della Repubblica s.n.c.
87100 Cosenza, Italy
Email: [email protected]

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