Eastern equine encephalitis: a classical case.
Abstract: We present the case of a 40-year-old man with rapidly deteriorating acute meningoencephalitis, finally diagnosed as eastern equine encephalitis (EEE). The course and timing in this patient are quite characteristic. EEE is an arthropod borneviral illness in which the mosquito serves as the vector. It is amongst the most severe of the arbovirus encephalitides and has a high mortality and morbidity. In nonfatal cases, residual neurological deficits are often severe and permanent. North American lineage of EEE is mainly found in the northeast especially along the coastal areas. EEE is primarily found in horses and other domestic mammals that remain outdoors nocturnally. In humans, symptoms range from nonspecific constitutional features to catastrophic neurological sequelae including death. Hyponatremia and increased cerebrospinal fluid (CSF) white blood cell count are independent predictors of poor outcomes. Diagnosis is suggestive by demonstrating IgM antibody in blood or CSF samples and can be confirmed by other serologic assay including immunohistochemistry and polymerase chain reaction (PCR). Measures recommended by the Center for Disease Control (CDC) for prevention include using repellents, protective clothing, screens, and eradication of mosquito breeding areas. EEE remains without cure and prevention is the best medicine.
Publication Date: 2015-02-14 PubMed ID: 25675592
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Summary
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This article presents a case study of a 40-year-old man suffering from Eastern equine encephalitis (EEE), a serious arthropod borne illness transmitted by mosquitoes, and discusses the diagnostic symptoms, prognosis, prevention measures, and lack of cure for the disease.
Introduction: What is Eastern Equine Encephalitis?
- Eastern equine encephalitis (EEE) is a viral illness transmitted to humans by mosquitoes.
- It is among the most severe encephalitides (inflammation of the brain) caused by the arbovirus family of viruses.
- Of those infected, the disease has a high rate of resulting in death or severe, residual neurological damage.
Geographical Prevalence and Transmission of EEE
- The North American lineage of EEE is primarily found in the northeastern United States, especially along coastal areas.
- Horses and other outdoor, nocturnal domestic mammals serve as key transmission hosts in these areas.
Symptoms, Diagnosis, and Prognosis of EEE
- Symptoms in humans can range from nonspecific constitutional symptoms (such as fever and malaise) to severe neurological complications, and even death.
- Prognostic indicators of poor outcomes include the presence of hyponatremia (low sodium levels) and an increased count of white blood cells in the cerebrospinal fluid (CSF).
- Diagnosis typically involves detecting the IgM antibody in blood or CSF samples, with additional confirmation coming from immunohistochemistry or polymerase chain reaction (PCR) tests.
Prevention and Current Treatment Options for EEE
- The Center for Disease Control (CDC) recommends a variety of prevention strategies, including using insect repellents, wearing protective clothing, installing screens, and eliminating mosquito breeding grounds.
- Currently, there is no known cure for EEE, making these preventative measures vital.
The key takeaway from the case presented in this article is that EEE is a highly severe and often deadly disease, with the severity of symptoms and rapid deterioration of the patient’s condition being defining characteristics. This only goes to underline the importance of preventive measures, as no cure for EEE currently exists.
Cite This Article
APA
Baig B, Mehta T, Khalid N, Chhabra L.
(2015).
Eastern equine encephalitis: a classical case.
Conn Med, 78(9), 529-531.
Publication
Researcher Affiliations
MeSH Terms
- Adult
- Disease Progression
- Encephalomyelitis, Eastern Equine / cerebrospinal fluid
- Encephalomyelitis, Eastern Equine / complications
- Encephalomyelitis, Eastern Equine / diagnosis
- Fatal Outcome
- Humans
- Magnetic Resonance Imaging
- Male
Citations
This article has been cited 2 times.- Baxter VK, Glowinski R, Braxton AM, Potter MC, Slusher BS, Griffin DE. Glutamine antagonist-mediated immune suppression decreases pathology but delays virus clearance in mice during nonfatal alphavirus encephalomyelitis. Virology 2017 Aug;508:134-149.
- Porter AI, Erwin-Cohen RA, Twenhafel N, Chance T, Yee SB, Kern SJ, Norwood D, Hartman LJ, Parker MD, Glass PJ, DaSilva L. Characterization and pathogenesis of aerosolized eastern equine encephalitis in the common marmoset (Callithrix jacchus). Virol J 2017 Feb 7;14(1):25.
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