West Nile virus encephalitis

Case contributed by Emmanouil Kalioras
Diagnosis certain


Headache, fever, seizures, rapid deteriation.

Patient Data

Age: 40 years
Gender: Male

Cortical thickening and T2 hyperintensity of the left mesial temporal lobe (best appreciated on saggital view).

No sign of restricted diffusion.

No clear contrast enhancement.

Case Discussion

The imaging differential diagnosis includes the following: viral encephalitis, low-grade tumor, focal cortical dysplasia and limbic encephalitis. 

Taking into consideration the symptoms, especially rapid clinical determination, the diagnosis of viral encephalitis is favored.

The patient underwent a lumbar puncture with PCR. 

CSF PCR for West Nile virus: positive.

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