Case of the Week
Section Editors: Matylda Machnowska1 and Anvita Pauranik2
1University of Toronto, Toronto, Ontario, Canada
2BC Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
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September 10, 2012
St. Louis Encephalitis (SLEV)
- SLEV belongs to the family Flaviviridae (group B arbovirus).
- Principal SLEV reservoirs include wild birds and domestic fowl, and the virus is transmitted to humans through mosquitoes.
- Clinical manifestations include mild flulike symptoms, drowsiness, occasional rigidity, and paraparesis. Diffuse encephalitides-like picture is sometimes seen. Older patients are at greater risk of developing clinical symptoms.
- Key Diagnostic Features: Bilateral symmetric hyperintense signal involving the substantia nigra. No hemorrhage, diffusion restriction, or enhancement is seen.
- DDx: Japanese encephalitis, Western equine encephalitis, Wilson's disease, Parkinson's disease
- Rx: Prevention measures include mosquito repellents, maintaining environmental cleanliness, and increasing public awareness. However, once patient is infected supportive therapy and antipyretics are useful.
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