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Volume 22, Number 9—September 2016
CME ACTIVITY - Research

Use of Testing for West Nile Virus and Other Arboviruses

Jakapat Vanichanan, Lucrecia Salazar, Susan H. Wootton, Elizabeth Aguilera, Melissa N. Garcia, Kristy O. Murray, and Rodrigo HasbunComments to Author 
Author affiliations: University of Texas Health Science Center at Houston, Houston, Texas, USA (J. Vanichanan, L. Salazar, S.H. Wootton, E. Aguilera, R. Hasbun); Baylor College of Medicine, Houston (M.N. Garcia, K.O. Murray)

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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).

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Page created: August 10, 2016
Page updated: August 16, 2016
Page reviewed: August 16, 2016
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
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