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Volume 9, Number 12—December 2003

Historical Review

Alexander the Great and West Nile Virus Encephalitis

John S. Marr* and Charles H. CalisherComments to Author 
Author affiliations: *Virginia Department of Health, Richmond, Virginia, USA; Colorado State University, Fort Collins, Colorado, USA

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Table

Medical history and physical examination of Alexander the Great

Patient characteristics Medical history Clinical symptoms
Male
Born in Macedonia
32 years of age
Soldier
Heavy drinking
Frequent bathing
Married to many wives
One son Ten years before death, traveled widely (Mediterranean, North Africa, and Middle East)
Unexplained fever 5 years previously
Penetrating right chest wound one year before final illness
Onset of final illness May 29, 323 BC
Death June 10, 323 BC Escalating fever associated with chills
Excessive thirst, diaphoresis
Acute abdominal pain
Single episode of back pain at of onset of fever
Increased weakness leading to prostration with intermittent periods of energy
Delirium
Aphonia
Terminal flaccid paralysis

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