Case Report: A Fatal Case of West Nile Virus Meningoencephalomyelitis in a Woman with Systemic Lupus Erythematosus Initially Misdiagnosed as SARS-CoV-2 Infection

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  • 1 III Division of Infectious Diseases, Luigi Sacco Hospital, Milan, Italy;
  • 2 Department of Biomedical and Clinical Sciences “Luigi Sacco”, Università degli Studi di Milano, Milano, Italy;
  • 3 Intensive Care Unit, Luigi Sacco Hospital, Milan, Italy;
  • 4 Neurology Unit, Luigi Sacco Hospital, Milan, Italy;
  • 5 Laboratory of Clinical Microbiology, Virology and Bioemergencies, Luigi Sacco Hospital, Milan, Italy

We present a fatal case of West Nile virus meningoencephalomyelitis initially misdiagnosed as COVID-19 in a 63-year-old Egyptian woman with a previous diagnosis of systemic lupus erythematosus. The patient’s medical history and immunosuppressive therapy, as well as the COVID-19 pandemic, substantially broadened the differential diagnosis of her encephalitis.

Author Notes

Address correspondence to Spinello Antinori, Department of Biomedical and Clinical Sciences “Luigi Sacco,” Università degli Studi di Milano, Via GB Grassi 74, Milano 20157, Italy. E-mail: spinello.antinori@unimi.it

Authors’ addresses: Marco Schiuma, Laura Pezzati, and Spinello Antinori, Department of Biomedical and Clinical Sciences “Luigi Sacco,” Università degli Studi di Milano, Italy, E-mails: marco.schiuma@unimi.it, laura.pezzati@unimi.it, and spinello.antinori@unimi.it. Elisabetta Ballone and Beatrice Borghi, Intensive Care Unit, Luigi Sacco Hospital, Milan, Italy, E-mails: elisabetta.ballone@asst-fbf-sacco.it and beatrice.borghi@asst-fbf-sacco.it. Maurizio Osio and Daniele Mattavelli, Neurology Unit, Luigi Sacco Hospital, Milan, Italy, E-mails: maurizio.osio@asst-fbf-sacco.it and daniele.mattavelli@asst-fbf-sacco.it. Laura Galimberti and Mario Corbellino, III Division of Infectious Diseases, Luigi Sacco Hospital, Milan, Italy, E-mails: laura.galimberti@asst-fbf-sacco.it and mario.corbellino@asst-fbf-sacco.it. Davide Mileto and Nadia Zanchetta, Laboratory of Clinical Microbiology, Virology and Bioemergencies, Luigi Sacco Hospital, Milan, Italy, E-mails: davide.mileto@asst-fbf-sacco.it and nadia.zanchetta@asst-fbf-sacco.it.

These authors contributed equally to this work.

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