RT Journal Article
SR Electronic
T1 Eastern Equine Encephalitis
JF Neurology: Clinical Practice
FD Lippincott Williams & Wilkins
SP e714
OP e721
DO 10.1212/CPJ.0000000000001079
VO 11
IS 5
A1 Mayra Montalvo
A1 Dana Ayoub
A1 Michael McGary
A1 Katrina Byrd
A1 Leana Mahmoud
A1 Leonard Mermel
A1 Bradford Thompson
A1 Linda Wendell
YR 2021
UL http://cp.neurology.org/content/11/5/e714.abstract
AB Purpose of Review To describe the clinical presentation, diagnosis, management, and outcomes of 4 confirmed Eastern equine encephalitis (EEE) cases and a review of the literature.Recent Findings There was a sharp rise in the number of EEE cases in the United States in 2019, with 38 confirmed cases and 15 deaths. Our institution cared for 10% of patients with neuroinvasive EEE nationwide. These were the first cases seen locally since 2010.Summary EEE virus causes one of the most lethal types of arboviral encephalitis in the United States with a mortality of 30%–40%. Manifestations of EEE infections can range from mild encephalopathy to coma. Common findings include CSF pleocytosis and involvement of the basal ganglia on MRI. Given the rarity of this disease and nonspecific findings, diagnosis can be challenging, and a high clinical suspicion is important. Management is mainly supportive, and the use of IV immunoglobulin remains controversial. Two of our 4 patients died; these patients had coma within 48 hours, hyponatremia, involvement of bilateral thalami and brainstem, status epilepticus, and severe brain dysfunction in EEG.