P146 | A rare case of West Nile virus encephalitis

Premises: West Nile Virus (WNV) is a member of the flavivirus genus and belongs to the Japanese encephalitis antigenic complex of the family Flaviviridae. WNV can cause neurological disease and death in humans in 1 over 1000 cases. WNV is commonly found in Africa, Europe, the Middle East, North America and West Asia. WNV is maintained in nature in a cycle involving transmission between birds and mosquitoes. Humans, horses and other mammals can be infected. Since May 2023 in Italy 332 cases of West Nile Virus infections were registered among humans and 191 of those were reported with the neuro-invasive form. Description of the case report: A 78 years old man was hospitalized in October 2023 in the Internal Medicine ward “Pietro Gatti” of the PO Perrino of Brindisi with fever (TC max 39 C), drowziness, deep asthenia and confusion. Blood coltures, general viral (Citomegalovirus, Epstein Barr and Herpes simplex 1-2) and autoimmune panel were negative. For the persistence of the neurological status of confusion and drawziness with incipient paraplegia, brain magnetic resonance imaging (MRI) and cerebrospinal fluid (CSF) sampling were performed with evidence of encephalitis and WNV IgG antibody sero-conversion in two serial specimen collected at a one week interval by enzyme-linked immunosorbent assay (ELISA).Conclusions: Among Internal Medicine wards in Italy it’s essential to consider WNV encephalitis among differential diagnoses when in contact with patients with incipient neurological signs of enecephalitis in particular during spring and summer time.