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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)

Main Article

Table 3

Laboratory results, treatment, and outcomes for 751 patients with meningitis and encephalitis, by West Nile virus testing, Houston, Texas, USA

Variable West Nile virus testing requested, no. (%), n = 281 West Nile virus testing not requested, no. (%), n = 470 p value*
Cerebrospinal fluid profile
Predominantly lymphocytes† 218 (78) 326 (71) 0.07
Protein >100 mg/dL 101 (36) 137 (29) 0.12
Glucose <45 mg/dL
27 (10)
79 (17)
0.005
Cerebrospinal fluid microbiological testing
Bacteria, culture 272 (96) 447 (95) 0.35
Mycobacteria, culture or PCR 102 (36) 89 (19) <0.001
Fungi, culture or antigen assay 91 (32) 71 (15) <0.001
Herpes simplex virus, PCR 174 (62) 157 (33) <0.001
Enterovirus, reverse transcription PCR
104 (37)
139 (30)
0.03
Magnetic resonance imaging of brain
139 (49)
151 (32)
<0.001
Management and outcomes
Hospitalization 276 (98) 449 (96) 0.06
Empirical antibiotic treatment 215 (77) 367 (78) 0.65
Empirical antiviral treatment 98 (35) 95 (20) <0.001
Adverse outcome‡
51 (18)
34 (7)
<0.001
Etiology
Unknown 206 (73) 312 (66) 0.051
Viral 46 (16) 114 (24) 0.017
Bacterial 16 (6) 27 (6) 1.00
Fungal 6 (2) 9 (2) 0.80
Mycobacterial 5 (1) 3 (1) 0.43
Noninfectious 2 (1) 5 (1) 1.00

*p<0.001 after Bonferroni correction considered statistically significant.
†Median leuckocytes, cells/mL (range) 134 (1–4275) for samples tested and 143 (0–49000) for samples not tested for West Nile virus; p = 0.017.
‡Glasgow Outcome Scale score 1–4 (14).

Main Article

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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