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Case report
Jamestown Canyon virus-mediated meningoencephalitis with unusual laboratory findings
  1. Dilpat Kumar1,
  2. Anmol Hans1,
  3. Fnu Warsha2 and
  4. Nicholas Helmstetter1
  1. 1Western Michigan University Homer Stryker MD School of Medicine, Kalamazoo, Michigan, USA
  2. 2Interfaith Medical Center, Brooklyn, New York, USA
  1. Correspondence to Dr Dilpat Kumar; dilpat.kumar{at}med.wmich.edu

Abstract

Jamestown Canyon virus (JCV) is a mosquito-borne orthobunyavirus that causes an acute febrile illness, meningitis or meningoencephalitis. Human infections in the USA are rare. A 59-year-old man was admitted with fever, headache and hallucinations and required transfer to intensive care due to worsening agitation. Lumbar puncture was significant for neutrophilic pleocytosis, low glucose and high protein. Cerebral spinal fluid (CSF) bacterial cultures were negative, however, the CSF analysis via ELISA returned positive for JCV IgM. Plaque reduction neutralisation tests on a serum sample revealed IgM for JCV with titres of 1:160, which confirmed the diagnosis of JCV meningoencephalitis as the titres for other arboviruses were low. The patient improved significantly with supportive care. Our case highlights an atypical laboratory presentation of neutrophilic pleocytosis on CSF in a viral meningoencephalitis and draws attention to the potential cross-reactivity with other arboviruses.

  • neurology (drugs and medicines)
  • meningitis
  • tropical medicine (infectious disease)

https://doi.org/10.1136/bcr-2021-242014

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    Footnotes

    • Twitter @nic_helm

    • Contributors DK and AH created the first draft. NH revised and reviewed the final manuscript. FW helped to collect and analyse the available literature.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.