Volume 22, Number 9—September 2016
CME ACTIVITY - Research
Use of Testing for West Nile Virus and Other Arboviruses
Table 1
Baseline characteristics and disease management, outcomes, and etiologies for 751 patients with meningitis or encephalitis, Houston, Texas, USA
| Variable |
No. (%) |
| Baseline characteristic | |
| Adult* | 567 (75) |
| Male | 357 (48) |
| White |
306 (41) |
| Concurrent medical condition | |
| Charlson Comorbidity Index score >1 | 70 (9) |
| HIV infection |
42 (6) |
| Clinical features | |
| Encephalitis† | 237 (32) |
| Illness onset during West Nile virus season‡ |
390 (52) |
| Testing performed | |
| West Nile virus serology | 281 (37) |
| Other arbovirus serology | 174 (23) |
| Magnetic resonance imaging of brain |
290 (39) |
| Management and outcomes | |
| Admission | 725 (97) |
| Received empirical antibiotic treatment | 582 (77) |
| Received empirical antiviral treatment | 193 (26) |
| Adverse outcome§ |
85 (11) |
| Etiologies | |
| Unknown | 518 (69) |
| Viral | 160 (21) |
| Enterovirus | 63 (8) |
| Herpes simplex virus | 48 (6) |
| West Nile virus | 32 (4) |
| Other¶ | 17 (2) |
| Bacterial# | 43 (6) |
| Fungal** | 15 (2) |
| Mycobacterium tuberculosis | 8 (1) |
| Noninfectious†† | 7 (1) |
*>18 y of age. Median age 31 (range 2 mo–92 y).
†Possible, probable or confirmed diagnosis of encephalitis (13).
‡Jun–Oct.
§Glasgow Outcome Scale score 1-4 (14 ).
¶Varicella zoster virus (n = 7), St. Louis encephalitis virus (n = 3), acute HIV infection (n = 3), cytomegalovirus (n = 2), Epstein-Barr virus (n = 1), influenza virus (n = 1).
#Streptococcus pneumoniae (n = 15), Mycoplasma pneumoniae (n = 5), Staphylococcus aureus (n = 3), Streptococcus agalactiae (n = 3), Haemophilus influenzae n = 3), Escherichia coli (n = 3), Listeria monocytogenes (n = 2), Enterococcus spp. (n = 2), Neisseria meningitides (n = 2), α-hemolytic Streptococcus (n = 1), Streptococcus pyogenes (n = 1), coagulase-negative Staphylococcus (n = 1), Brucella sp. (n = 1), Treponema pallidum (n = 1).
**Cryptococcus neoformans (n = 14), Histoplasma capsulatum (n = 1).
††Malignancies (n = 3), systemic lupus erythematosus (n = 1), sarcoidosis (n = 1), acute disseminated encephalomyelitis (n = 1), cerebral aneurysm (n = 1).