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Abstract

Most affected humans with west-nile virus (WNV), a mosquito-borne virus of the flaviviridae family, remain asymptomatic, while a minority may develop neurological manifestation such as meningitis, encephalitis or a flaccid paralysis. Gastrointestinal  symptoms such as anorexia and abdominal pain are less common, whereas full blown symptomatic acute pancreatitis has only been described twice in the literature. These cases occurred in the Netherlands and in Israel where WNV is fairly endemic. We report the first clinical case in North America of a previously healthy 52 year old man who developed full blown WNV meningo-encephalitis with concurrent acute pancreatitis. Acute WN viral meningo-encephalitis was confirmed by a lumbar puncture, while other causes of meningitis/encephalitis were excluded. Acute WNV pancreatitis was diagnosed clinically as well as by abnormal serological markers including elevated amylase and lipase levels. The patient was treated conservatively, and his symptoms gradually improved until full recovery, requiring a total of three weeks from onset. WNV and its complications are reviewed, in addition to a description of prior cases of pancreatitis associated with WNV infection.

Keywords: West Nile virus; Infection; Meningitis; Encephalitis; Meningoencephalitis; Acute pancreatitis; Mosquitos