Cauda equina arachnoiditis – a rare manifestation of West Nile virus neuroinvasive disease: A case report

Table 1 Laboratory results in a patient with West Nile virus neuroinvasive disease and cauda equina arachnoiditis

Parameter	Day tested 41	Day tested 10	Reference range
Cerebrospinal fluid examination
Cell count/mm3	99	90	0-5
Mononuclear cells (%)	80	96	Mononuclear 100%
Proteins (g/L)	1.143	1.0	0.17–0.37
Glucose (% of blood glucose)	32%	52%	60%-70%
Blood examination
C-reactive protein (mg/L)	0.2	7.3	< 5.0
White blood cells (× 109/L)	9.1	9.7	4.0–10.0
Platelets (× 109/L)	156	150	100-400
Red blood cells (× 1012/L)	4.73	5.59	4.4-5.8
Hemoglobin (g/L)	128	149	120–180
Bilirubin (μmol/L)	-	20	3.0–20.0
Aspartate-aminotransferase (U/L)	37	32	11–38
Alanine-aminotransferase (U/L)	27	31	12–48
Gamma-glutamyltransferase (U/L)	-	77	11–55
Lactate dehydrogenase (U/L)	206	234	< 241

¹First cerebrospinal fluid examination on day 6.

Table 2 Virology results in a patient with West Nile virus neuroinvasive disease and cauda equina arachnoiditis

Virus	Day tested	Serology				RT-PCR
		Serum ELISA IgMa/IgGb	CSF ELISA IgMa/IgGb	Serum IFA IgM/IgG	IgG avidityc	CSF	Urine	Serum
TBEV	8	Neg (0.32)/Neg (4.61)	Neg (0.24)/Neg (< 2)	NT	NT	Neg	Neg	Neg
WNV	8	Pos (4.40)/Pos (29.31)	Pos (4.61)/Pos (44.67)	NT	Low (3%)	Neg	Neg	Neg
	15	Pos (4.18)/Pos (115.23)
	22	Pos (4.47)/Pos (143.64)
USUV	8	NT/Neg (10.95)	NT/Neg (12.04)	NT	NT	Neg	Neg	Neg
TOSV	8	NT	NT	Neg/Neg	NT	Neg	Neg	Neg
TAHV	8	NT	NT	NT	NT	Neg	Neg	Neg
BHAV	8	NT	NT	NT	NT	Neg	Neg	Neg

^aratio < 8 negative, 8-1.1 borderline, > 1.1 positive.

^bRU/ml < 16 negative, 16-22 borderline, > 22 positive.

^cavidity index < 40% low, 40-60% borderline, > 60% high. TBEV: Tick-borne encephalitis virus; WNV: West Nile virus; USUV: Usutu virus; TOSV: Toscana virus; TAHV: Tahyna virus; BHAV: Bhanja virus; NT: Not tested; RT-PCR: reverse-transcriptase polymerase chain reaction; ELISA: Enzyme-linked immunosorbent assays; CSF: Cerebrospinal fluid; IFA: Immunofluorescence assay.